Association between hearing loss and suicidal ideation: Discrepancy between pure tone audiometry and subjective hearing level

Abstract

BackgroundThis study aimed to evaluate hearing loss by combining pure tone audiometry (PTA) with subjective hearing level concerning suicidal ideation. MethodsA total of 23,215 individuals from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2009 and 2013 were included. PTA was categorized according to average audiometric threshold levels: normal (≤25 dB), mild (26–40 dB), and moderate-severe (>40 dB). The subjective hearing level was categorized as “no discomfort,” “mild discomfort,” and “considerable discomfort” for hearing without a hearing aid. Next, we classified hearing loss into nine groups by combining PTA and subjective hearing levels. Suicidal ideation was defined as answering yes to the following question: “Have you ever seriously thought about killing yourself in the past 1 year?” We conducted chi-square tests and multiple logistic regression analyses. ResultsAmong the 23,215 participants aged ≥19 years (mean age 46.52 years), 3,214 (13%) reported having suicidal ideation. According to PTA, moderate to severe hearing loss was related to suicidal ideation (OR = 1.19, 95 % CI = 1.01–1.41). Subjective hearing loss was associated with suicidal ideation (mild: OR = 1.41, 95 % CI = 1.21–1.65; considerable: OR = 1.57, 95 % CI = 1.20–2.05). Moreover, as the subjective hearing level increased, the ORs of suicidal ideation increased in individuals with moderate to severe hearing loss (mild: OR = 1.52, 95 % CI = 1.24–1.88; considerable: OR = 1.81, 95 % CI = 1.39–2.36). LimitationsThe cross-sectional study limits the interpretation of causal relationships. ConclusionsSubjective hearing loss was more strongly associated with suicidal ideation than hearing loss as measured by PTA.