Psychiatric Comorbidity in Chronic Tinnitus: Depression and Anxiety in an Otolaryngology Outpatient Cohort

Abstract

Purpose: Chronic subjective tinnitus is commonly accompanied by psychological distress; however, its independent relationship with depressive and anxiety symptoms in otolaryngology outpatients has not been fully delineated. This study sought to estimate the prevalence of mood symptoms among adults with chronic tinnitus and to determine whether tinnitus severity contributes independently to psychological burden. Patients and Methods: In this cross-sectional study, 100 adults with subjective tinnitus of at least six months' duration were evaluated at a tertiary otolaryngology clinic. Participants completed the Tinnitus Handicap Inventory (THI), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI). Prevalence estimates were compared with population-level data. Associations between tinnitus severity and mood symptoms were examined using correlation analyses and multivariable linear regression adjusted for age, sex, and hearing status. Results: Mean scores were 47.2 +/- 18.3 for THI, 16.1 +/- 10.4 for BDI-II, and 19.5 +/- 11.2 for BAI. Tinnitus severity showed moderate positive associations with depressive (r = 0.50) and anxiety symptoms (r = 0.48), both p < 0.001. After adjustment, THI scores remained independently associated with higher BDI-II ((3 = 0.42, p < 0.001) and BAI scores ((3 = 0.39, p < 0.001). Severe tinnitus (THI >= 58) was linked to increased odds of moderate-to-severe depression (OR 3.10, 95% CI 1.52-6.30) and anxiety (OR 2.84, 95% CI 1.40-5.72). Clinically relevant depressive and anxiety symptoms were identified in 28% and 31% of participants, respectively. Conclusion: Greater tinnitus severity is independently associated with elevated symptom severity of depression and anxiety. These findings underscore the importance of routine mental health screening and multidisciplinary management in ENT practice.