Abstract
Objective: 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. Method: 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. Results: 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. Conclusions: 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.
Highlights
Chronic tinnitus denotes a long-lasting (>3 months) auditory percept without sound stimulation
Depressive symptoms, anxiety, and somatization symptoms fully mediated the effect of tinnitus-related distress (TRD) on mental and physical health-related quality of life (HRQoL)
The present study investigated joint effects of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other, non-tinnitus-related somatization symptoms on mental or physical health-related quality of life (HRQoL) in female and male patients with chronic tinnitus
Summary
Chronic tinnitus denotes a long-lasting (>3 months) auditory percept without sound stimulation. Chronic tinnitus-related distress (TRD) is often expressed alongside—or potentially in lieu of—psychological or psychosomatic phenomena including depressive symptoms [4,5], anxiety [6,7,8], or other somatization symptoms that may or may not occur in the context of identifiable medical factors such as vertigo, sweats, blurred vision, headaches, periods of weakness, pain, nausea, or shortness of breath [9,10]. Tinnitus-related distress [20,21,22], anxiety [23], depressive symptoms [24,25], and somatization symptoms [26,27,28] have all been reported to have a negative impact on patients’ health-related quality of life (HRQoL). Somatoform conditions or any somatic condition that is experienced as psychologically burdensome may affect both indices
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