Clinical Analysis Of Anxiety, Depression And Sleep Disorder In Patients With Tinnitus

Background and Objectives:Tinnitus is commonly described as a perception of sound that is not related to an external acoustic source or electrical stimulation.10%-30%of people all over the world influenced (more than200million people), while0.14%-0.28%of them with anxiety,0.4-0.5%of them complaining problem in daily life. Tinnitus can cause disruption of sleep, anxiety and depression symptom. Otherwise, the symptoms make tinnitus seriously. So, it is quite important and ineluctable in the process of diagnosis and treatment of tinnitus in psychology. The aim of this study is to investigate relationship of sleep feature, anxiety, depression and clinical feature in patients with tinnitus, and explore the characteristic in psychology and sleep quality. Then, it is benefit for us to find disorder in mental psychology early, in order to improve our therapy and increase curative effect.Subjects and Methods:260patients with tinnitus were enrolled in the Zhejiang province people’s hospital and1st Affiliated Hospital of Zhejiang University from June,2013to May,2014. The levels of anxiety and depression in tinnitus patients were evaluated respectively by the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index questionnaire (PSQI) and Tinnitus Handicap Inventory(THI).The same Researcher collected history and the questionnaire results. After completed, the questionnaires were analysied and calculated by statistics.Results:1. Incidence of tinnitus patients with sleep disorder was48.5%(126cases), among them,19.6%of man and28.9%of women. The incidence of anxiety was14.6%(38cases), among them,4.2%of man and10.4%of women. The incidence of depression was16.2%(42cases), among them,5.8%of men and10.4%of women.2. The major risk factors of anxiety symptom were including gender (female VS male, OR=2.384), the course of the disease (acute VS chronic, OR=0.253), tinnitus loudness (high VS low, OR-5.624; medium VS low, OR=15.350), situation of sleep disorder (disorder VS normal, OR=5.106). There were no correlation with anxiety and age, tinnitus location, tinnitus frequency and level of hearing damage (P>0.05).The major risk factors of depression symptom were including the course of the disease (acute VS chronic, OR=2.947), tinnitus loudness (high VS low, OR=8.464), situation of sleep disorder (disorder VS normal, OR=4.541). There were no correlation with depression and gender, age, tinnitus location,tinnitus frequency and level of hearing damage(P>0.05).3. There were51.6%of tinnitus patients accompanying various degrees of daytime dysfunction, but less of them used sleeping drugs (5.0%). There were48.5%patients with lower subjective sleep quality,38.4%of them with difficulty falling sleep,26.6%of them with sleep time shorten,18.8%of them with sleep efficiency reduced. 4. The PSQI score of anxiety group and depression group were higher than no anxiety and depression group (P=0.020, P=0.015), lower than anxiety and depression group (P=0.022, P=0.017).5. There was positive relation in THI and SAS scores (r=0.823, P=0.000), THI and SDS scores (r=0.738, P=0.000). The scores of PSQI, SAS and SDS in THI level3, level4and level5groups were significantly different to THI level land level2groups (P＜0.05).6. The score of THI was associated with level of hearing loss (r=0.199, P=0.001), loudness of tinnitus (r=0.421, P=0.000), anxiety symptom (r=0.551, P=0.000), depression symptom (r=0.515, P=0.000), and sleep disorder (r=0.320, P=0.000).Conclusions:1. The prevalence of sleep disorder is high in tinnitus patients. Some patients are often accompanied with anxiety and depression symptoms, especially. There were significant correlation between the sleep disturbance and symptom of anxiety and depression.2. The risk factors of anxiety in tinnitus patients included female, duration, loudness of tinnitus and sleep disorders. The risk factors of depression in tinnitus patients were duration, loudness of tinnitus and sleep disturbance.3. There was positive relationship between tinnitus severity and sleep disorders, anxiety and depression, hearing loss was a weaker potent predictor than which anxiety and depression for tinnitus severity. The patients with THI>36was at risk of mental problem, who should be taken by psychological and intervention therapy, combined with sleep improvement.