Is the degree of discomfort caused by tinnitus in normal-hearing individuals correlated with psychiatric disorders?

Objective: To evaluate the annoyance of tinnitus in normal-hearing patients and to correlate it with outer hair cell function and with anxiety and depression disorders.

Study Design: Case-control study.

Setting: Tertiary care medical center.

Subjects And Methods: Sixty-eight patients with tinnitus (study group) and a control group consisting of 46 subjects without tinnitus were studied. The subjects ranged in age from 20 to 45 years and had a hearing threshold of up to 25 dB in the frequency range of 500 to 8000 Hz. The subjects were submitted to otoacoustic emission (OAE) tests. Tinnitus annoyance was evaluated using the Tinnitus Handicap Inventory, and anxiety and depression were measured using the Beck Anxiety and Depression Inventories.

Results: In the study group, 67% of the transient-evoked OAE tests were altered, with the observation of significant differences for all frequencies tested. In addition, 65.2% of the distortion product-evoked OAE tests were altered at 3000, 6000, and 8000 Hz, and this difference was significant when compared with control. Anxiety (44.1%) and depression (33.3%) were significantly more frequent among patients with tinnitus. Tinnitus annoyance was not correlated with the OAE results or tinnitus duration but showed a correlation with the presence of anxiety and depression. In the study group, no difference in tinnitus annoyance, anxiety, or depression was observed between patients with normal and altered OAE tests.

Conclusion: This study showed altered OAE in patients with tinnitus and normal hearing. It also demonstrated a positive correlation between the annoyance of tinnitus and anxiety and depression in normal-hearing patients.