Boecking Benjamin, Biehl Raphael, Brueggemann Petra, Mazurek Birgit
Tinnitus Center, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
J Clin Med. 2021 Jun 25;10(13):2798. doi: 10.3390/jcm10132798.
To investigate the joint impact of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other somatization symptoms on health-related quality of life (HRQoL) in female vs. male patients with chronic tinnitus.
Three-hundred-and-fifty-two patients with chronic tinnitus completed audiological testing and a psychological assessment battery that comprised-among other measures-German versions of the Tinnitus Questionnaire, Hospital Anxiety and Depression Scale, Somatic Symptom Scale-8, and Health-Related Quality of Life scale. Descriptive analyses examined associations as well as within- and between-gender differences of the measured variables. Gender-specific serial indirect effects analyses aimed to explain the impact of TRD on HRQoL through psychological processes, notably anxiety, depressive symptoms, and somatization symptoms.
Both female and male patients yielded lower mental than physical HRQoL and negative associations between the measured psychological variables and HRQoL. Compared to male patients, female patients reported higher levels of tinnitus-related- and wider psychological distress, other somatization symptoms (e.g., headaches), and impairments in mental and physical HRQoL. For each gender, depressive symptoms, anxiety, and somatization symptoms fully mediated the effect of TRD on mental and physical HRQoL. A double-dissociation revealed an interaction of somatization symptoms and depression on the TRD-HRQoL association in women, and of somatization symptoms and anxiety in men.
In patients with chronic tinnitus, psychological constructs account for reported impairments in both mental and physical HRQoL. To improve patients' HRQoL, treatment conceptualizations should consider gender-specific psychological expressions of low mood or anxiety.
探讨耳鸣相关困扰（TRD）、焦虑、抑郁症状及其他躯体化症状对慢性耳鸣女性和男性患者健康相关生活质量（HRQoL）的联合影响。
352例慢性耳鸣患者完成了听力测试和一套心理评估量表，其中包括德语版耳鸣问卷、医院焦虑抑郁量表、躯体症状量表-8以及健康相关生活质量量表等。描述性分析考察了测量变量之间的关联以及性别内和性别间的差异。特定性别的系列间接效应分析旨在通过心理过程，尤其是焦虑、抑郁症状和躯体化症状来解释TRD对HRQoL的影响。
女性和男性患者的心理HRQoL均低于生理HRQoL，且所测量的心理变量与HRQoL之间存在负相关。与男性患者相比，女性患者报告的耳鸣相关困扰和更广泛的心理困扰、其他躯体化症状（如头痛）以及心理和生理HRQoL受损程度更高。对于每种性别，抑郁症状、焦虑和躯体化症状完全介导了TRD对心理和生理HRQoL的影响。双重解离揭示了女性中躯体化症状与抑郁在TRD-HRQoL关联上的相互作用，以及男性中躯体化症状与焦虑的相互作用。
在慢性耳鸣患者中，心理因素导致了心理和生理HRQoL的受损。为改善患者的HRQoL，治疗方案应考虑情绪低落或焦虑的性别特异性心理表现。
