Abstract
BackgroundIn the last decades, research focused on gender-related features in patients with tinnitus has often led to controversial results. The complex clinical picture of tinnitus patients often consists of an interdependent relationship between audiological symptoms and co-occurrent psychological disorders, which can complicate the diagnostic evaluation.MethodsTherefore, we studied 107 patients with tinnitus, investigating their psychological comorbidities in the light of gender differences. All patients were evaluated with ENT/audiological and psychological examination to consider presence/absence, type and gender distribution of psychopathological comorbidities. Patients completed questionnaires on tinnitus distress (Tinnitus Handicap Inventory, THI), anxiety (Beck Anxiety Inventory, BAI), depression (Beck Depression Inventory, BDI), metacognition (Metacognition Questionnaire-30, MCQ-30) and worry (Penn State Worry Questionnaire). The influence of gender on the relationship between tinnitus distress and psychological comorbidities was investigated with simple moderation analyses using the SPSS PROCESS macro.ResultsThe total sample included 65 male and 42 female patients (60.7 vs. 39.3%), matched for age and duration of tinnitus. We found no significant differences for tinnitus distress (THI total score, THI subscales) and MCQ-30 subscales, except for the control over thoughts, where men showed significantly higher scores than women (p = 0.045). Also, in our sample women showed significantly higher values for depression (BDI total score, p = 0.019), anxiety (BAI total score, p = 0.010) and worries (PSQW total score, p = 0.015). Moderation analyses revealed a significant influence of gender on the relationship of tinnitus distress with depression: higher scores of tinnitus distress were associated with significantly elevated levels of depression amongst men. No further gender influences could be observed in our sample.DiscussionIn conclusion, our results indicate general gender differences for psychological comorbidities in tinnitus patients, with women reporting more depression, anxiety and worries. Men, on the other hand, showed a higher need to control their thoughts. Additionally, our results indicate that men might have more coping problems with increasing levels of tinnitus distress, leading to increased depressive symptoms. Nevertheless, several gender related aspects in tinnitus patients remain unclear, thus warranting the need future studies in this field.
Highlights
Tinnitus is a multifactorial disorder and it involves the perception of sounds, such as ringing or buzzing in the ear or head without detectable external source (Cima et al, 2019)
In accordance with previous research, increased levels of tinnitus distress were associated with higher levels of depression, anxiety and worries (Durai and Searchfield, 2016; Pattyn et al, 2016; Salazar et al, 2019)
We found that higher tinnitus distress was associated with positive beliefs about worry, negative beliefs about the controllability of thoughts and danger of worry, cognitive confidence, beliefs about the need to control thoughts, and cognitive self-consciousness
Summary
Tinnitus is a multifactorial disorder and it involves the perception of sounds, such as ringing or buzzing in the ear or head without detectable external source (Cima et al, 2019). Recent studies reveal that about 30% of adults can experience tinnitus but overall prevalence varied over 8-fold from 5.1 to 42.7% (McCormack et al, 2016). Approximately one-third of adults with tinnitus experience it as bothersome and feel impaired in their daily performance (Tunkel et al, 2014). As reported by Cima et al (2019), bothersome tinnitus might be better described as a negative emotional and auditory experience. The complex clinical picture of tinnitus patients often consists of an interdependent relationship between audiological symptoms and co-occurrent psychological disorders, which can complicate the diagnostic evaluation
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