Pilot study to evaluate psychiatric co-morbidity in tinnitus patients with and without hyperacusis

Abstract

The relationship between hyperacusis with chronic tinnitus and psychiatric disorders has long been ignored. A prevalence of hyperacusis in 59% of tinnitus patients was found using the Structured Tinnitus Interview (STI). Twenty-four per cent of the subgroup noticed the hyperacusis before the tinnitus had begun. Study participants were 163 consecutive inpatients with chronic tinnitus. A Tinnitus Questionnaire assessed the degree of severity of the tinnitus. Hyperacusis was assessed in a structured interview, with the Hyperacusis Questionnaire and by Uncomfortable Loudness Levels. We conducted a psychiatric interview to check for acute psychiatric disorders, and additional questionnaires assessed different psychosomatic and psychiatric symptoms. In 69% of the patients there was an acute psychiatric diagnosis present. Because precise criteria for sound intolerance have seldom been defined, we computed the cut-off points for the German ‘Questionnaire on Hypersensitivity to Sounds’ (GÜF), Uncomfortable Loudness Levels to tones (ULLt) and to broadband noises (ULLn). Our hypothesis that affective and anxiety disorders correlate more highly with a diagnosis of tinnitus with hyperacusis was confirmed. This was particularly true when we diagnosed hyperacusis using the GÜF or the ULL. It is assumed that, in most cases, the hyperacusis does not contribute to the psychiatric disorder, but that the existing disorders present a risk factor for the development of hyperacusis.