Arayici Mehmet Emin, Kose Ali, Arayici Sema Gultekin
Department of Public Health, Faculty of Medicine, Dokuz Eylül University, Izmir, Türkiye.
Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylül University, Izmir, Türkiye.
Eur Arch Otorhinolaryngol. 2025 Jul 12. doi: 10.1007/s00405-025-09562-y.
This study aimed to determine the nationwide prevalence of self-reported hearing loss and depressive symptoms among adults and to evaluate the association between hearing loss severity and depression.
This cross-sectional analysis was based on data from 22,725 participants aged ≥ 15 years who participated in the 2022 Türkiye Health Survey. Sampling weights were applied to ensure that the sample was representative of the national population, which corresponds to an estimated 59,281,923 individuals. Hearing loss and depressive symptoms were assessed through self-report and the Patient Health Questionnaire (PHQ-8), respectively. Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs), adapting comprehensively for sociodemographic variables, lifestyle factors, and chronic comorbidities.
The mean age of participants was 42.4 years (95% CI: 42.2-42.7; SE: 0.131), with a median of 41 years and a range of 15 to 102 years. The prevalence of any self-reported hearing loss was 9.21% (95% CI: 9.19-9.29), including mild-to-moderate (7.57%, 95% CI: 7.57-7.61) and severe (1.55%, 95% CI: 1.52-1.58). Moderate depressive symptoms were reported by 2.76% (95% CI: 2.71-2.79), and severe depressive symptoms by 1.74% (95% CI: 1.73-1.74). Depression prevalence similarly increased with age and was significantly higher among women (p < 0.001). Among participants without any hearing loss, 19.5% reported at least mild depression. Of note, individuals experiencing any form of hearing loss, 43.5% reported at least mild depressive symptoms. Multivariable analyses indicated a clear dose-dependent association between depressive symptom severity and hearing loss. Compared with normal hearing, mild-to-moderate hearing loss significantly increased odds of moderate (aOR = 2.245, 95% CI: 1.703-2.959, p < 0.001) and severe depressive symptoms (aOR = 3.124, 95% CI: 2.230-4.376, p < 0.001). Severe or CHL further increased the odds of moderate (aOR = 4.158, 95% CI: 2.424-7.132, p < 0.001) and severe depressive symptoms (aOR = 7.174, 95% CI: 4.115-12.506, p < 0.001).
This nationally representative study demonstrates a significant self-reported burden of hearing loss and depression among individuals in Türkiye, highlighting strong, graded associations between hearing loss severity and depressive symptoms. The findings emphasize the importance of integrating audiological and mental health services to identify at-risk populations early and provide timely interventions. Future longitudinal studies should need to first use diagnostic tests to confirm self-reported data, and explore the potential causal relationships and benefits of hearing rehabilitation in reducing depressive symptoms.
本研究旨在确定全国范围内成年人自我报告的听力损失和抑郁症状的患病率，并评估听力损失严重程度与抑郁症之间的关联。
本横断面分析基于22725名年龄≥15岁的参与者的数据，这些参与者参加了2022年土耳其健康调查。应用抽样权重以确保样本代表全国人口，估计有59281923人。听力损失和抑郁症状分别通过自我报告和患者健康问卷（PHQ-8）进行评估。多变量逻辑回归模型用于估计调整后的优势比（aOR）和95%置信区间（CI），全面考虑社会人口学变量、生活方式因素和慢性合并症。
参与者的平均年龄为42.4岁（95%CI：42.2-42.7；标准误：0.131），中位数为41岁，范围为15至102岁。自我报告的任何听力损失患病率为9.21%（95%CI：9.19-9.29），包括轻度至中度（7.57%，95%CI：7.57-7.61）和重度（1.55%，95%CI：1.52-1.58）。报告有中度抑郁症状的占2.76%（95%CI：2.71-2.79），重度抑郁症状的占1.74%（95%CI：1.73-1.74）。抑郁症患病率同样随年龄增加而上升，且在女性中显著更高（p<0.001）。在没有任何听力损失的参与者中，19.5%报告至少有轻度抑郁。值得注意的是，有任何形式听力损失的个体中，43.5%报告至少有轻度抑郁症状。多变量分析表明抑郁症状严重程度与听力损失之间存在明显的剂量依赖性关联。与听力正常相比，轻度至中度听力损失显著增加了中度（aOR=2.245，95%CI：1.703-2.959，p<～0.001）和重度抑郁症状的几率（aOR=3.～124，95%CI：2.230-4.376，p<0.001）。重度或重度感音神经性听力损失进一步增加了中度（aOR=4.158，95%CI：2.424-7.132，p<0.001）和重度抑郁症状的几率（aOR=7.174，95%CI：4.115-12.506，p<0.001）。
这项具有全国代表性的研究表明，土耳其个体中自我报告的听力损失和抑郁症负担较重，突出了听力损失严重程度与抑郁症状之间的强烈分级关联。研究结果强调了整合听力和心理健康服务以早期识别高危人群并及时提供干预的重要性。未来的纵向研究应首先使用诊断测试来确认自我报告的数据，并探索听力康复在减轻抑郁症状方面的潜在因果关系和益处。
