Abstract
Recent work demonstrates that hearing impairment is much more common than previously suspected. The disability may be unrecognized or denied by the sufferer and may attract social stigma rather than sympathy from others. The effect on mental health is surprisingly neglected. Early studies of psychiatric patients suggested hearing impairment is an important cause of paranoid illness, but more recent studies of wider populations have failed to confirm this association. Hearing impairment is unrelated to intellect when controlled for age, but is an important differential diagnosis of dementia in the elderly. Evidence accumulates to suggest that the hearing impaired are vulnerable to depression, social stress and isolation, but reliable controlled studies of psychiatric sequelae are needed.