Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus

Abstract

Objective: Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus. Design: Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES). Study sample: 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32. Results: The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4. Conclusions: Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).

Key Words:

• Tinnitus
• Psychiatric disorder
• Personality disorder
• Structured clinical interview for DSM disorders
• SCID

Declaration of interest: Dr Sahlsten has received travel grant from Nexstim for an international Congress on therapeutic use of rTMS. Dr. Taiminen has received a lecturer honorarium from Astra-Zeneca, Bayer, Bristol-Myers Squibb, Efeko, Eisai, GlaxoSmithKline, Lilly, Lundbeck, Nexstim, Orion Pharma, Pfizer, Schering-Plough and UCB. Dr. Joutsa received a lecturer honorarium from Boehringer-Ingelheim, travel grants from Abbvie and research grants from Lundbeck and the Orion Research Foundation. PhD Holm has received a travel grant from ResMed. Professor Jääskeläinen has received lecturer honoraria from Nexstim, Orion Pharma, Pfizer, and Ratiopharm as well as a grant for academic research from Orion Pharma. Others involved in the study declared no conflicts of interest.

This study was supported by Finnish governmental University Hospital grants (EVO), the Finnish Research Foundation of Ear Diseases, and State research funding from the Hospital District of Southwest Finland.