When Sound Fades: Depression and Anxiety in Adults with Hearing Loss—A Cross-Sectional Study

Abstract

Background: Hearing loss is a prevalent sensory impairment with substantial psychosocial consequences. This cross-sectional study investigated the relationship between audiometric hearing loss and mood disturbances in adults aged 18–65 years who reported hearing difficulties for at least six months. Methods: Objective hearing level was assessed using the better-ear pure-tone average (PTA), and subjective hearing handicap was measured with the Hearing Handicap Inventory for Adults (HHIA). Standardized mood assessments included the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Results: The study found that higher HHIA scores, indicating greater perceived hearing handicap, were strongly correlated with more severe depression and anxiety (ρ ≈ 0.45 and 0.38, respectively; p < 0.001). In contrast, objective PTA showed weaker associations with mood scores. Regression analyses, adjusted for age and gender, confirmed that perceived hearing handicap (HHIA) was the strongest independent predictor of both depression (standardized β ≈ 0.37, p < 0.001) and anxiety (β ≈ 0.33, p < 0.01), accounting for about 30% of the variance in mood scores. Nearly one-third of participants had clinically significant depression (BDI-II ≥ 20), which is substantially higher than community norms. The cross-sectional design and potential selection bias are limitations. Conclusions: Even mild-to-moderate hearing loss can result in significant depressive and anxious symptoms when individuals perceive themselves as handicapped. Early identification of hearing problems, routine psychosocial screening (e.g., a simple two-question survey), and integrated care are essential for improving quality of life. © 2025 by the authors.