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Wu H, Xia Y, Luo Q, Li Q, Jiang H, Xiong Y. Psychological Distress and Meniere's Disease: A Bidirectional Two-Sample Mendelian Randomization Study. Otolaryngol Head Neck Surg 2024; 170:1391-1403. [PMID: 38123520 DOI: 10.1002/ohn.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/15/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study is aim to explore the causal relationship between anxiety, depression, neuroticism, and Meniere's disease (MD). STUDY DESIGN Two-sample bidirectional Mendelian randomization (MR) analyses. SETTING IEU, FinnGen, CTG, and UKB databases. METHODS The genome-wide association studies data for anxiety, depression, neuroticism, and MD involved over 357,957 participants. MR was performed to explore relationships between anxiety, depression, neuroticism, and MD. Sensitivity analyses were performed to assess the robustness of the MR results. Reverse MR was used to exclude the possibility of reverse causality. Finally, multivariate MR was performed to explore the collinear relationships between neuroticism subclusters. RESULTS MR results showed that anxiety and depression are not causes of MD, nor does MD cause anxiety and depression. Elevated neuroticism sum score is a cause of anxiety, depression, and MD, but MD does not lead to an increase in the level of neuroticism sum score. Further analysis showed that the 5 subclusters of neuroticism often feel lonely, mood often goes up and down, often feel fed-up, feelings easily hurt, and sensitivity to environmental stress and adversity are causes of MD. Multivariate MR analysis results suggested that the 5 neuroticism subclusters have a collinear relationship. CONCLUSION Anxiety and depression are not causative factors of MD, and vice versa. Elevated neuroticism levels serve as a shared causative factor for anxiety, depression, and MD. Identification and effective management of neuroticism is a potential target for preventing and treating MD.
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Affiliation(s)
- Huadong Wu
- Department of Otolaryngology, The first Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Otorhinolaryngology Institute of Jiangxi Province, Nanchang Univeristy, Nanchang, Jiangxi, China
| | - Yunyan Xia
- Department of Otolaryngology, The first Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Otorhinolaryngology Institute of Jiangxi Province, Nanchang Univeristy, Nanchang, Jiangxi, China
- National Clinical Research Center for Otolaryngologic Diseases, Jiangxi Branch Center, Nanchang, China
| | - Qing Luo
- Department of Otolaryngology, The first Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Otorhinolaryngology Institute of Jiangxi Province, Nanchang Univeristy, Nanchang, Jiangxi, China
- National Clinical Research Center for Otolaryngologic Diseases, Jiangxi Branch Center, Nanchang, China
| | - Qiang Li
- Department of Otolaryngology, Wenshan Zhuang and Miao Autonomous Prefecture People's Hospital, Wenshan, China
| | - Hongqun Jiang
- Department of Otolaryngology, The first Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Otorhinolaryngology Institute of Jiangxi Province, Nanchang Univeristy, Nanchang, Jiangxi, China
- National Clinical Research Center for Otolaryngologic Diseases, Jiangxi Branch Center, Nanchang, China
| | - Yuanping Xiong
- Department of Otolaryngology, The first Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Otorhinolaryngology Institute of Jiangxi Province, Nanchang Univeristy, Nanchang, Jiangxi, China
- National Clinical Research Center for Otolaryngologic Diseases, Jiangxi Branch Center, Nanchang, China
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Prior KN, Bond VE, Bond MJ. Does Illness Behavior Contribute to the Understanding of Self-Efficacy and Quality of Life Among People With Hearing Loss? A Test of Concept. Am J Audiol 2022; 31:211-219. [PMID: 34905416 DOI: 10.1044/2021_aja-21-00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The study sought to first confirm the mediating role of self-efficacy (SE) in the link between hearing loss and reduced quality of life (QOL) and introduce the construct of illness behavior (IB) as a further correlate of self-reported QOL that may itself be mediated by SE. METHOD Cross-sectional data were attained using a questionnaire that was completed by 61 adults with self-reported acquired hearing loss. RESULTS Support was provided for low SE being a barrier to QOL, with hearing loss only predictive of emotional QOL when SE was an intermediary (mediating) variable. Cognitive and affective indices of IB also predicted QOL. Those participants with elevated emotional distress and, to a lesser extent, exaggerated concerns for their health, were found to have both lower SE and poorer QOL. CONCLUSIONS Attempts to replicate these findings longitudinally and with larger and more diverse samples (e.g., congenital or illness-derived hearing loss) are encouraged. A more objective assessment of hearing loss may also reduce the potential for spurious associations that may arise from the use of self-reported data. Nevertheless, the analytical results provide encouragement for the continued consideration of IB in the evaluation of the well-being of individuals with hearing loss. It is proposed that IB could be a useful supplement to the study of motivation among this cohort, such as an addition to the commonly used Health Belief Model, to improve the predictive validity of appropriate health behaviors.
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Affiliation(s)
- Kirsty N. Prior
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Verity E. Bond
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Malcolm J. Bond
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Correia F, Medeiros AB, Castelhano L, Cavilhas P, Escada P. Personality and psychopathology in Ménière's disease. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021; 72:344-351. [PMID: 34844672 DOI: 10.1016/j.otoeng.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/18/2020] [Indexed: 10/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES Psychological factors in vertigo patients have been extensively studied but the role of anxiety and personality traits in the clinical course of Ménière's disease (MD) is unknown. The objectives of this study are to identify and characterize psychopathology in MD and to find risk factors for an increased rate and intensity of crisis and chronic symptoms. MATERIALS AND METHODS We performed a transversal study in all patients diagnosed with definite MD in our department during a 5-year period. Sample subjects were interviewed in 3 steps: first, an otorhinolaryngologist collected information about clinical and pharmacological background of MD; second, a psychiatrist screened for mood, anxiety and personality disorders; in a third stage, the patient completed the DHI (Dizziness Handicap Inventory), STAI-Y (State Trait Anxiety Inventory), NEO-PI-R (Neo Personality Inventory Reviewed) and VAS (Visual Analogue Scale) for vertigo and dizziness. Statistical analysis was performed to search for risk factors for multiple and intense crisis and chronic symptoms. RESULTS Thirty-four patients completed all 3 phases of the study. A predominant dysfunctional personality trait was identified in 80% of patients (predominantly cluster C type), 35% were being treated with psychiatric medication and 34.4% had a considerable mood or anxiety disorder. All patients scored high (>7) in VAS during crisis. There was a statistically significant positive correlation between crisis rate and STAI, anxiety-subscale (N1) in NEO-PI-R, VAS and DHI scores (p<.044). Crises were more common in bilateral MD (p=.041). DHI scores were higher with higher STAI and N1 (p=.001). Disease duration and pure tone average were found to have a positive moderate correlation (p=.017). CONCLUSIONS The positive correlations between crisis rate, chronic dizziness and anxiety-related personality traits reveal a bidirectional and intimate relationship between personality, anxiety and MD, affecting these patients' quality of life. These results support the relevance of prospecting adjuvant psychological and psychiatric approaches to these patients.
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Affiliation(s)
- Filipe Correia
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal.
| | - Ana Beatriz Medeiros
- Serviço de Psiquiatria e Saúde Mental, Hospital Garcia de Orta, Almada, Portugal
| | - Luís Castelhano
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal
| | - Pedro Cavilhas
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal
| | - Pedro Escada
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal
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Lovato A, Frosolini A, Marioni G, de Filippis C. Higher incidence of Ménière's disease during COVID-19 pandemic: a preliminary report. Acta Otolaryngol 2021; 141:921-924. [PMID: 34524036 DOI: 10.1080/00016489.2021.1913288] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic represented a stressful event. OBJECTIVES The incidence of newly diagnosed Ménière's disease (MD) patients before and during COVID-19 at our Institution was calculated. MATERIALS AND METHODS The period 2018-2020 was considered. Incidence was calculated as number of annual first MD diagnoses divided by the number of annual first audiological evaluations. RESULTS One hundred and eighty-three patients were considered. Annual incidence of MD at our institution was 1.3% in 2018, 1.2% in 2019, and 3.2% in 2020, resulting in a significant increase during COVID-19 pandemic (2018 vs. 2020, p=.00001; 2019 vs. 2020, p=.00001). MD patients in 2020 presented a higher number of vertigo attacks (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.04) and higher Dizziness Handicap Inventory questionnaire (DHI) values (2018 vs. 2020, p=.02; 2019 vs. 2020, p=.03). During COVD-19 pandemic, MD patients reported significantly higher State-Trait Anxiety Inventory (STAI) - Y1 (2018 vs. 2020, p=.04; 2019 vs. 2020, p=.03). CONCLUSIONS AND SIGNIFICANCE A higher incidence of MD first diagnosis was calculated during COVID-19 pandemic; furthermore, MD patients presented with more vertigo attacks and higher DHI values. These could be associated with the higher state anxiety during COVID-19 pandemic.
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Affiliation(s)
- Andrea Lovato
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
| | - Andrea Frosolini
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Cosimo de Filippis
- Department of Neuroscience DNS, Audiology Unit at Treviso Hospital, University of Padova, Treviso, Italy
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Efficacy of Yokukansan, a traditional Japanese herbal medicine, in patients with dizziness and irritability. Auris Nasus Larynx 2021; 48:864-869. [PMID: 33526322 DOI: 10.1016/j.anl.2021.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/03/2021] [Accepted: 01/20/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Irritability is an emotional stress symptom that causes or exacerbates dizziness. Antidepressants may be helpful for some conditions that are accompanied by irritability; however, they do not completely inhibit irritability. Yokukansan (YKS), a traditional Japanese herbal medicine, has been used for neurosis, insomnia, and children's irritability and night crying. The study investigated the efficacy of YKS in nystagmus in patients with chronic dizziness and irritability. METHODS Twenty-two cases with chronic dizziness and irritability were reviewed retrospectively. The patients were divided into two groups: control patients (0-7 days of treatment) and YKS-treated patients (YKS cases; >7 days of treatment). Dizziness before and during (after, in the controls) YKS treatment was evaluated by scoring the nystagmus intensity on a 5-point scale. The average scores were calculated within a maximum of 6 months before and during or after treatment. The normalized scores were also calculated. The optimal treatment regimen was calculated via receiver operating characteristic (ROC) curve analysis. RESULTS There were six control cases (1 male, 5 females; mean age: 59.5 years). There were 16 YKS cases (3 males, 13 females; mean age: 61.8 years). While the group mean nystagmus intensity scores significantly decreased from 1.18 to 0.73 in the YKS cases, it did not change in the control cases. The group mean of the normalized nystagmus intensity scores during treatment was 0.73 in the YKS cases. The results of the ROC curve analysis indicated the optimal cut-off period of the YKS treatment was 10 days. CONCLUSION The oral administration of YKS for more than 10 days was optimal. The treatments with YKS could be a good option for the treatments of vertigo.
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Correia F, Medeiros AB, Castelhano L, Cavilhas P, Escada P. Personality and psychopathology in Ménière's disease. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020; 72:S0001-6519(20)30152-7. [PMID: 33059851 DOI: 10.1016/j.otorri.2020.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Psychological factors in vertigo patients have been extensively studied but the role of anxiety and personality traits in the clinical course of Ménière's disease (MD) is unknown. The objectives of this study are to identify and characterize psychopathology in MD and to find risk factors for an increased rate and intensity of crisis and chronic symptoms. MATERIALS AND METHODS We performed a transversal study in all patients diagnosed with definite MD in our department during a 5-year period. Sample subjects were interviewed in 3 steps: first, an otorhinolaryngologist collected information about clinical and pharmacological background of MD; second, a psychiatrist screened for mood, anxiety and personality disorders; in a third stage, the patient completed the DHI (Dizziness Handicap Inventory), STAI-Y (State Trait Anxiety Inventory), NEO-PI-R (Neo Personality Inventory Reviewed) and VAS (Visual Analogue Scale) for vertigo and dizziness. Statistical analysis was performed to search for risk factors for multiple and intense crisis and chronic symptoms. RESULTS Thirty-four patients completed all 3 phases of the study. A predominant dysfunctional personality trait was identified in 80% of patients (predominantly cluster C type), 35% were being treated with psychiatric medication and 34.4% had a considerable mood or anxiety disorder. All patients scored high (>7) in VAS during crisis. There was a statistically significant positive correlation between crisis rate and STAI, anxiety-subscale (N1) in NEO-PI-R, VAS and DHI scores (p<.044). Crises were more common in bilateral MD (p=.041). DHI scores were higher with higher STAI and N1 (p=.001). Disease duration and pure tone average were found to have a positive moderate correlation (p=.017). CONCLUSIONS The positive correlations between crisis rate, chronic dizziness and anxiety-related personality traits reveal a bidirectional and intimate relationship between personality, anxiety and MD, affecting these patients' quality of life. These results support the relevance of prospecting adjuvant psychological and psychiatric approaches to these patients.
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Affiliation(s)
- Filipe Correia
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal.
| | - Ana Beatriz Medeiros
- Serviço de Psiquiatria e Saúde Mental, Hospital Garcia de Orta, Almada, Portugal
| | - Luís Castelhano
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal
| | - Pedro Cavilhas
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal
| | - Pedro Escada
- Serviço de Otorrinolaringologia, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; Nova Medical School, Universidade Nova, Lisboa, Portugal
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Depression in Ménière's disease: a systematic review and meta-analysis. The Journal of Laryngology & Otology 2020; 134:293-301. [DOI: 10.1017/s002221512000081x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
AbstractBackgroundMénière's disease is a debilitating chronic peripheral vestibular disorder associated with psychiatric co-morbidities, notably depression.MethodsDatabase searches were performed to identify studies that assessed depression in Ménière's disease. Metrics used to diagnose depression were extracted, along with the prevalence of depression in each study.ResultsFifteen studies from 8 different countries reported on 6587 patients. The weighted average age was 55.3 years (range, 21–88 years). Depression was measured by eight different scales, with Zung's Self-Rating Depression Scale used most often. A weighted proportion of 45.9 per cent of patients (confidence interval = 28.9–63.3) were depressed. Weighted averages (± standard deviations) of Beck's Depression Inventory and the Illness Behavior Questionnaire – Dysphoria were 8.5 ± 7.9 and 2.4 ± 1.7, respectively.ConclusionThe prevalence of depression in patients with Ménière's disease is nearly 50 per cent. Treating otolaryngologists should have a low threshold to screen and refer appropriately. Identifying and treating depression should allow for improvement of overall quality of life in patients with Ménière's disease.
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Nada EH, Ibraheem OA, Hassaan MR. Vestibular Rehabilitation Therapy Outcomes in Patients With Persistent Postural-Perceptual Dizziness. Ann Otol Rhinol Laryngol 2019; 128:323-329. [DOI: 10.1177/0003489418823017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives: Persistent postural-perceptual dizziness (PPPD) represents an important category of vertigo. Medical treatment and psychotherapy provide convenient control of symptoms. However, these management strategies can have inconvenient side effects and short-term relief, respectively. Vestibular rehabilitation therapy (VRT) is a self-conducted habituation program that can be personalized to the subject’s needs to give adequate symptom relief without side effects. The present study aims to test the effect of VRT on patients with PPPD. Methods: Participants were diagnosed as having PPPD by the exclusion of organic vestibular lesions. The study involved 2 groups with PPPD: Group I, treated with the VRT, and Group II, treated with the VRT plus placebo. The Dizziness Handicap Inventory (DHI), a self-assessment scale, was used to evaluate the VRT outcomes. Results: There was a significant decrease in functional, physical, and total scores on the DHI in both groups after VRT. Adding the placebo did not have supplementary outcomes. The patients who did not benefit from the VRT had a significantly longer duration of PPPD, more complex aggravating factors, more composite VRT exercises, and a higher DHI score than the patients who benefited from VRT. Conclusions: Customized VRT adequately reduced symptoms and improved quality of life in subjects with PPPD.
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Affiliation(s)
- Ebtessam H. Nada
- Audio-Vestibular Medicine Unit, Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine, University of Zagazig, Zagazig, Egypt
| | - Ola A. Ibraheem
- Audio-Vestibular Medicine Unit, Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine, University of Zagazig, Zagazig, Egypt
| | - Mohammad R. Hassaan
- Audio-Vestibular Medicine Unit, Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine, University of Zagazig, Zagazig, Egypt
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Abstract
HYPOTHESIS Stress and unusual events are associated with a higher likelihood of attacks and increased symptom severity in Menière's disease (MD). BACKGROUND MD is an unpredictable condition which severely impacts the quality of life of those affected. It is thought that unusual activity and stress may act as an attack trigger in MD, but research in this area has been limited to date. METHODS This was a longitudinal study conducted over two phases. A mobile phone application was used to collect daily data on Menière's attacks and individual symptoms (aural fullness, dizziness, hearing loss, and tinnitus), as well as prevalence of unusual events (phase I), and stress levels (phase II). There were 1,031 participants (730 women, mean age 46.0 yr) in phase I and 695 participants (484 women, mean age 47.7 yr) in phase II. Panel data regression analyses were employed to examine for associations between unusual events/stress and attacks/symptoms, including the study of 24 hours lead and lag effects. RESULTS Unusual events and higher stress levels were associated with higher odds of Menière's attacks and more severe symptoms. The odds of experiencing an attack were 2.94 (95% confidence interval [CI] 2.37, 3.65) with reporting of unusual events and increased by 1.24 (95% CI 1.20, 1.28) per unit increase in stress level. Twenty-four hour lead (OR 1.10 [95% CI 1.07, 1.14]) and lag (OR 1.10 [95% CI 1.06, 1.13]) effects on attacks were also found with increases in stress. CONCLUSION This study provides the strongest evidence to date that stress and unusual events are associated with attacks and symptom exacerbation in MD. Improving our understanding of stress and unusual events as triggers in Menière's may reduce the uncertainty associated with this condition and lead to improved quality of life for affected individuals.
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Piper TJ, Paulsen TD, Black L, Brees TN, Schulte JJ. Meniere's Disease: An Overview and Training Considerations. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Esin RG, Khairullin IK, Mukhametova ER, Esin OR. Persistent postural-perceptual dizziness. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:28-33. [DOI: 10.17116/jnevro20171174128-33] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Sakagami M, Kitahara T, Okayasu T, Yamashita A, Hasukawa A, Ota I, Yamanaka T. Negative prognostic factors for psychological conditions in patients with audiovestibular diseases. Auris Nasus Larynx 2016; 43:632-6. [DOI: 10.1016/j.anl.2016.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 02/01/2016] [Accepted: 02/10/2016] [Indexed: 11/15/2022]
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Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, Sabbe BCG. Tinnitus and anxiety disorders: A review. Hear Res 2015; 333:255-265. [PMID: 26342399 DOI: 10.1016/j.heares.2015.08.014] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/06/2015] [Accepted: 08/27/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND The most common form of tinnitus is a subjective, auditory, and distressing phantom phenomenon. Comorbidity with depression is high but other important psychiatric disorders such as anxiety disorders have received less attention. The current paper reviews the literature on the associations between tinnitus and anxiety disorders and the underlying pathophysiology, and discusses the clinical implications. METHODOLOGY PubMed and Web of Science were searched for all articles published up until October 2014 using combinations of the following search strings "Tinnitus", "Anxiety disorder", "Panic Disorder", "Generalized Anxiety Disorder", "Post traumatic stress disorder", "PTSD" "Social Phobia", "Phobia Disorder", "Obsessive Compulsive Disorder", "Agoraphobia". RESULTS A total of 117 relevant papers were included. A 45% lifetime prevalence of anxiety disorders is reported in tinnitus populations, while an important overlap in associated (sub)cortical brain areas and cortico-subcortical networks involved in attention, distress, and memory functions is suggested. A disturbed hypothalamic-pituitary-adrenal axis function can be found in tinnitus and in anxiety disorders but, in comorbidity, the direction of the dysfunction is unclear. CONCLUSION Comorbidity is high and screening for and treatment of anxiety disorders is recommended in moderate to severe tinnitus, as, given the overlap in the structural and functional brain circuitries involved, theoretically, their management could improve (subjective) levels of tinnitus although further empirical research on this topic is required.
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Affiliation(s)
- T Pattyn
- University of Antwerp, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium; University Department of Psychiatry, Campus Antwerp University Hospital, Antwerp, Belgium.
| | - F Van Den Eede
- University Department of Psychiatry, Campus Antwerp University Hospital, Antwerp, Belgium; University of Antwerp, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium
| | - S Vanneste
- University of Antwerp, Department of Translational Neuroscience, Faculty of Medicine, Antwerp, Belgium; University of Texas, School of Behavioral and Brain Sciences, Dallas, Richardson, TX, United States
| | - L Cassiers
- University of Antwerp, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium; University Department of Psychiatry, Campus Antwerp University Hospital, Antwerp, Belgium
| | - D J Veltman
- VU University Medical Centre, Department of Psychiatry and EMGO Institute of Health and Care Research and Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - P Van De Heyning
- University of Antwerp, Department of Translational Neuroscience, Faculty of Medicine, Antwerp, Belgium; Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - B C G Sabbe
- University of Antwerp, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp, Belgium; University Department of Psychiatry, Campus Psychiatric Hospital Duffel, Duffel, Belgium
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Furukawa M, Kitahara T, Horii A, Uno A, Imai T, Ohta Y, Morihana T, Inohara H, Mishiro Y, Sakagami M. Psychological condition in patients with intractable Meniere's disease. Acta Otolaryngol 2013; 133:584-9. [PMID: 23675809 DOI: 10.3109/00016489.2012.759274] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS Physicians should consider additional treatment strategies for Meniere's disease patients with a long history of disease and hearing loss in the secondary affected ear and also provide psychological support regarding future progressive bilateral hearing loss. OBJECTIVES To treat intractable Meniere's disease patients effectively, we need to understand the psychological condition of each patient. We examined the state of neurosis and depression in patients and correlated this with demographic and background information. METHODS Between 1998 and 2009, we enrolled 207 patients with intractable Meniere's disease in this prospective study. We used the Cornell Medical Index and the Self-rating Depression Scale to evaluate their psychological condition. We also obtained demographic and background information relating to sex, age, duration of disease, vertigo frequency, hearing level in bilateral sides, and plasma vasopressin level. RESULTS Neurosis and depression was diagnosed in 40.1% and 60.4%, respectively, of patients with intractable Meniere's disease. Our results showed that surgical treatment significantly improved vertigo and hearing ability in patients with no psychological symptoms compared with those exhibiting psychological symptoms. Patients with a longer duration and worse hearing level in the secondary affected ear had a significantly higher incidence of mental illness than those with a shorter duration and better level of hearing.
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Affiliation(s)
- Masashi Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Osaka University School of Medicine, Osaka, Japan
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Weise C, Kleinstäuber M, Hesser H, Westin VZ, Andersson G. Acceptance of tinnitus: validation of the tinnitus acceptance questionnaire. Cogn Behav Ther 2013; 42:100-15. [PMID: 23627873 DOI: 10.1080/16506073.2013.781670] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The concept of acceptance has recently received growing attention within tinnitus research due to the fact that tinnitus acceptance is one of the major targets of psychotherapeutic treatments. Accordingly, acceptance-based treatments will most likely be increasingly offered to tinnitus patients and assessments of acceptance-related behaviours will thus be needed. The current study investigated the factorial structure of the Tinnitus Acceptance Questionnaire (TAQ) and the role of tinnitus acceptance as mediating link between sound perception (i.e. subjective loudness of tinnitus) and tinnitus distress. In total, 424 patients with chronic tinnitus completed the TAQ and validated measures of tinnitus distress, anxiety, and depression online. Confirmatory factor analysis provided support to a good fit of the data to the hypothesised bifactor model (root-mean-square-error of approximation = .065; Comparative Fit Index = .974; Tucker-Lewis Index = .958; standardised root mean square residual = .032). In addition, mediation analysis, using a non-parametric joint coefficient approach, revealed that tinnitus-specific acceptance partially mediated the relation between subjective tinnitus loudness and tinnitus distress (path ab = 5.96; 95% CI: 4.49, 7.69). In a multiple mediator model, tinnitus acceptance had a significantly stronger indirect effect than anxiety. The results confirm the factorial structure of the TAQ and suggest the importance of a general acceptance factor that contributes important unique variance beyond that of the first-order factors activity engagement and tinnitus suppression. Tinnitus acceptance as measured with the TAQ is proposed to be a key construct in tinnitus research and should be further implemented into treatment concepts to reduce tinnitus distress.
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Affiliation(s)
- Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Germany.
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Hio S, Kitahara T, Uno A, Imai T, Horii A, Inohara H. Psychological condition in patients with an acoustic tumor. Acta Otolaryngol 2013; 133:42-6. [PMID: 23039793 DOI: 10.3109/00016489.2012.709322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS This study showed that patients with acoustic tumor (AT) with hearing loss in the contralateral side had severe mood disturbances. It is important for physicians to provide patients who have better hearing in the tumor side with adequate information regarding the possibility of profound bilateral hearing loss and how to communicate with others in such situations. OBJECTIVES We examined the pretreatment status as regards neurosis and/or depression of patients with an AT using the Cornell Medical Index (CMI) and Self-rating Depression Scale (SDS) and clarified the relationship with the patients' background. METHODS We enrolled 30 patients with unilateral AT between 1997 and 2010. At the time of diagnosis, we examined each patient's psychological condition, sex, age, laterality, tumor size, hearing level on bilateral side, facial paresis, headache, and canal paresis. RESULTS In all, 20.0% of AT patients were diagnosed with neurosis using the CMI and 26.7% had depression according to the SDS. χ(2) analysis showed that patients with AT with hearing deterioration on the contralateral side had mental illness significantly more often than those with normal hearing on the contralateral side. Multivariable regression analysis revealed that the pretreatment status of hearing level on the contralateral side significantly affected the patients' psychological condition.
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Affiliation(s)
- Sachiko Hio
- Department of Otolaryngology-Head and Neck Surgery, Osaka University School of Medicine, Osaka, Japan
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18
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Pollak L, Segal P, Stryjer R, Stern HG. Beliefs and emotional reactions in patients with benign paroxysmal positional vertigo: a longitudinal study. Am J Otolaryngol 2012; 33:221-5. [PMID: 21872359 DOI: 10.1016/j.amjoto.2011.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 06/22/2011] [Accepted: 07/13/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychologic studies in patients with benign paroxysmal positional vertigo (BPPV) are scarce, considering the high frequency of the disorder. We performed a repeated-measures design questionnaire study in a cohort of patients with BPPV before and after treatment to investigate the dynamics of the psychologic findings and possible treatment consequences. METHODS Thirty-seven consecutive patients with idiopathic BPPV participated in the study. During the first visit and 2 to 3 months after therapy, the patients completed 4 questionnaires: the Dizziness Handicap Inventory, the Illness Perception Questionnaire-Revised, the Intolerance of Uncertainty Scale, and the State-Trait Anxiety Inventory. RESULTS The scores for all questioned items did not change before and after treatment except for the physical handicap scores. Correlation was found between the grade of functional and emotional impact of the disease and belief in consequences as well as anxiety levels of the patients. Moreover, uncertainty scores were in correlation with emotional impact, anxiety levels, and perceived consequences of the disease. The belief in personal control of the condition was correlated with the belief in treatment control and understanding of the disease. CONCLUSION The main finding in this study is the lack of a significant change in beliefs and emotional reactions in patients with BPPV after treatment of their condition. Physicians dealing with BPPV should be aware that the disease is not solely a somatic condition but has a serious impact on the patient's mental state. Selected patients might benefit from anxiolytic medication.
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Affiliation(s)
- Lea Pollak
- Department of Neurology, Assaf Harofeh Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel.
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Thong J, Woods C, Lo S, Knight J. Type A personality in dizzy patients. Clin Otolaryngol 2007; 32:417-8. [DOI: 10.1111/j.1749-4486.2007.01476.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thong JF, Lo S, Knight J, Wood C. Type A Personality in Patients with Dizziness. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708600702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Jiun Fong Thong
- Department of Otolaryngology St. George's Hospital London, UK
| | - Stephen Lo
- Department of Otolaryngology St. George's Hospital London, UK
| | - Jeffrey Knight
- Department of Otolaryngology St. George's Hospital London, UK
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