Department of Statistics, University of Illinois Urbana-Champaign, Champaign, Illinois, USA.
Department of Speech and Hearing Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois, USA.
Ear Hear. 2024;45(3):775-786. doi: 10.1097/AUD.0000000000001467. Epub 2024 Jan 31.
OBJECTIVES: Hearing loss affects the emotional well-being of adults and is sometimes associated with clinical depression. Chronic tinnitus is highly comorbid with hearing loss and separately linked with depression. In this article, the authors investigated the combined effects of hearing loss and tinnitus on depression in the presence of other moderating influences such as demographic, lifestyle, and health factors. DESIGN: The authors used the National Health and Nutrition Examination Survey data (2011-2012 and 2015-2016) to determine the effects of hearing loss and tinnitus on depression in a population of US adults (20 to 69 years). The dataset included the Patient Health Questionnaire-9 for depression screening, hearing testing using pure-tone audiometry, and information related to multiple demographic, lifestyle, and health factors (n = 5845). RESULTS: The statistical analysis showed moderate to high associations between depression and hearing loss, tinnitus, and demographic, lifestyle, and health factors, separately. Results of logistic regression analysis revealed that depression was significantly influenced by hearing loss (adjusted odds ratios [OR] = 3.0), the functional impact of tinnitus (adjusted OR = 2.4), and their interaction, both in the absence or presence of the moderating influences. The effect of bothersome tinnitus on depression was amplified in the presence of hearing loss (adjusted OR = 2.4 in the absence of hearing loss to adjusted OR = 14.9 in the presence of hearing loss). Conversely, the effect of hearing loss on depression decreased when bothersome tinnitus was present (adjusted OR = 3.0 when no tinnitus problem was present to adjusted OR = 0.7 in the presence of bothersome tinnitus). CONCLUSIONS: Together, hearing loss and bothersome tinnitus had a significant effect on self-reported depression symptoms, but their relative effect when comorbid differed. Tinnitus remained more salient than hearing loss and the latter's contribution to depression was reduced in the presence of tinnitus, but the presence of hearing loss significantly increased the effects of tinnitus on depression, even when the effects of the relevant demographic, lifestyle, or health factors were controlled. Treatment strategies that target depression should screen for hearing loss and bothersome tinnitus and provide management options for the conditions.
目的：听力损失会影响成年人的情绪健康，有时与临床抑郁症有关。慢性耳鸣与听力损失高度共存，并与抑郁分别相关。在本文中，作者研究了听力损失和耳鸣对抑郁症的综合影响，同时考虑了其他调节因素，如人口统计学、生活方式和健康因素。
设计：作者使用国家健康和营养检查调查数据（2011-2012 年和 2015-2016 年），在 20 至 69 岁的美国成年人中确定听力损失和耳鸣对抑郁症的影响。该数据集包括用于抑郁症筛查的患者健康问卷-9、使用纯音测听进行的听力测试，以及与多个人口统计学、生活方式和健康因素相关的信息（n=5845）。
结果：统计分析显示，抑郁与听力损失、耳鸣以及人口统计学、生活方式和健康因素之间存在中度至高度关联，分别如此。逻辑回归分析的结果表明，听力损失（调整后的优势比[OR] = 3.0）、耳鸣的功能影响（调整后的 OR = 2.4）及其相互作用均显著影响抑郁，无论是否存在调节因素。在存在听力损失的情况下，烦人的耳鸣对抑郁的影响会放大（在不存在听力损失的情况下调整后的 OR = 2.4，在存在听力损失的情况下调整后的 OR = 14.9）。相反，当存在烦人的耳鸣时，听力损失对抑郁的影响会降低（在不存在耳鸣问题的情况下调整后的 OR = 3.0，在存在烦人的耳鸣的情况下调整后的 OR = 0.7）。
结论：总的来说，听力损失和烦人的耳鸣对自我报告的抑郁症状有显著影响，但它们的合并影响有所不同。耳鸣比听力损失更突出，并且当存在耳鸣时，听力损失对抑郁的贡献降低，但当存在听力损失时，耳鸣对抑郁的影响显著增加，即使控制了相关的人口统计学、生活方式或健康因素的影响也是如此。针对抑郁的治疗策略应筛查听力损失和烦人的耳鸣，并为这些病症提供管理方案。
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