The Impact of Tinnitus on Mental Health
,
Abstract
Background: Tinnitus, the perception of sound without external stimuli, affects approximately 14.4% of adults globally and significantly impacts mental health. It is commonly associated with anxiety, depression, and cognitive dysfunction, contributing to a decreased quality of life. Tinnitus can be classified as subjective or objective, and its severity and associated psychological distress vary widely among individuals.
Methods: A comprehensive review of literature published between 2010 and 2024 was conducted using databases such as PubMed, Scopus, Web of Science, and Google Scholar. Keywords related to tinnitus and mental health (e.g., anxiety, depression, mood disorders) were used to identify human studies exploring the psychological impact of tinnitus.
Results: Research consistently demonstrates that individuals with tinnitus experience different rates of anxiety and depression, with prevalence rates ranging from 18.5% to 48.33% for anxiety and 6% to 84% for depression. Shared neural pathways, including the anterior cingulate cortex, insula, and amygdala, contribute to both tinnitus and mental health conditions. Psychological interventions such as Cognitive behavioral therapy (CBT) and mindfulness-based therapies (MBIs) have shown effectiveness in reducing tinnitus distress and improving mental well-being.
Conclusion: Tinnitus has a significant impact on mental health, contributing to anxiety, depression, and sleep disturbances. A multidisciplinary approach addressing both auditory and psychological aspects of tinnitus is crucial for effective management. Further research is needed to optimize treatment strategies and understand the complex interplay between tinnitus and mental health.
1. Dubey KK. Tinnitus: Our Current Understanding. European Journal of Clinical Medicine. 2021 Jun 16;2(3):1–4.
2. Jarach CM, Lugo A, Scala M, van den Brandt PA, Cederroth CR, Odone A, et al. Global Prevalence and Incidence of Tinnitus. JAMA Neurol. 2022 Sep 1;79(9):888.
3. Hackenberg B, Döge J, O’Brien K, Bohnert A, Lackner KJ, Beutel ME, et al. Tinnitus and Its Relation to Depression, Anxiety, and Stress—A Population-Based Cohort Study. J Clin Med. 2023 Feb 1;12(3):1169.
4. Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: Results from the HUNT Study. J Psychosom Res. 2010 Sep;69(3):289–98.
5. Karoui M, Kchaou A, Amri G, Nefzi H, Kammoun R, Ellouz F. Anxiety, depression and tinnitus: a cross-sectional study about 60 cases. European Psychiatry. 2022 Jun 1;65(S1):S467–S467.
6. Korkut S, Altıntaş M. The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During theCOVID ‐19 Pandemic and the Impact of Pandemic on Tinnitus. Clinical Otolaryngology. 2024 Nov 28;49(6):725–32.
7. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hear Res. 2016 Mar;333:255–65.
8. Karoui M, Kchaou A, Amri G, Nefzi H, Kammoun R, Ellouz F. Anxiety, depression and tinnitus: a cross-sectional study about 60 cases. European Psychiatry. 2022 Jun 1;65(S1):S467–S467.
9. Ooms E, Vanheule S, Meganck R, Vinck B, Watelet JB, Dhooge I. Tinnitus severity and its association with cognitive and somatic anxiety: a critical study. European Archives of Oto-Rhino-Laryngology. 2012 Nov 23;269(11):2327–33.
10. Chen Y, Xia W, Chen H, Feng Y, Xu J, Gu J, et al. Tinnitus distress is linked to enhanced resting‐state functional connectivity from the limbic system to the auditory cortex. Hum Brain Mapp. 2017 May 23;38(5):2384–97.
11. Vanneste S, Plazier M, der Loo E van, de Heyning P Van, Congedo M, De Ridder D. The neural correlates of tinnitus-related distress. Neuroimage. 2010 Aug 15;52(2):470–80.
12. Crocetti A, Forti S, Ambrosetti U, Bo L Del. Questionnaires to evaluate anxiety and depressive levels in tinnitus patients. Otolaryngology–Head and Neck Surgery. 2009 Mar;140(3):403–5.
13. Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in Patients with Tinnitus: A Systematic Review. Otolaryngology–Head and Neck Surgery. 2019 Jul 26;161(1):28–35.
14. Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol. 2022 May 2;13.
15. Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. Tinnitus and depression. The World Journal of Biological Psychiatry. 2011 Oct 13;12(7):489–500.
16. Trevis KJ, McLachlan NM, Wilson SJ. Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention. Front Psychol. 2016 Aug 24;7.
17. Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol. 2022 May 2;13.
18. Joos K, Vanneste S, De Ridder D. Disentangling Depression and Distress Networks in the Tinnitus Brain. PLoS One. 2012 Jul 12;7(7):e40544.
19. Han KM, Ko YH, Shin C, Lee JH, Choi J, Kwon DY, et al. Tinnitus, depression, and suicidal ideation in adults: A nationally representative general population sample. J Psychiatr Res. 2018 Mar;98:124–32.
20. Ooms E, Meganck R, Vanheule S, Vinck B, Watelet J, Dhooge I. Tinnitus Severity and the Relation to Depressive Symptoms. Otolaryngology–Head and Neck Surgery. 2011 Aug 31;145(2):276–81.
21. Niemann U, Brueggemann P, Boecking B, Mazurek B, Spiliopoulou M. Development and internal validation of a depression severity prediction model for tinnitus patients based on questionnaire responses and socio-demographics. Sci Rep. 2020 Mar 13;10(1):4664.
22. Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: Results from the HUNT Study. J Psychosom Res. 2010 Sep;69(3):289–98.
23. Gomaa MAM, Elmagd MHA, Elbadry MM, Kader RMA. Depression, Anxiety and Stress Scale in patients with tinnitus and hearing loss. European Archives of Oto-Rhino-Laryngology. 2014 Aug 27;271(8):2177–84.
24. Chakrabarty S, Mudar R, Chen Y, Husain FT. Contribution of Tinnitus and Hearing Loss to Depression: NHANES Population Study. Ear Hear. 2024 May 31;45(3):775–86.
25. Chen X, Hu K, Song H, Yin L, Kaijser M, Gurholt TP, et al. Depression, anxiety and brain volume after hearing loss and tinnitus: cohort study in the UK Biobank. BJPsych Open. 2024 Mar 1;10(2):e37.
26. Pierzycki RH, Kitterick PT. Insomnia, Anxiety and Depression in Adult Cochlear Implant Users With Tinnitus. Ear Hear. 2021 Jan;42(1):235–43.
27. Crönlein T, Langguth B, Pregler M, Kreuzer PM, Wetter TC, Schecklmann M. Insomnia in patients with chronic tinnitus: Cognitive and emotional distress as moderator variables. J Psychosom Res. 2016 Apr;83:65–8.
28. Richter K, Zimni M, Tomova I, Retzer L, Höfig J, Kellner S, et al. Insomnia Associated with Tinnitus and Gender Differences. Int J Environ Res Public Health. 2021 Mar 19;18(6):3209.
29. Herr RM, Loerbroks A, Bosch JA, Seegel M, Schneider M, Schmidt B. Associations of Organizational Justice with Tinnitus and the Mediating Role of Depressive Symptoms and Burnout—Findings from a Cross-Sectional Study. Int J Behav Med. 2016 Apr 11;23(2):190–7.
30. Hébert S, Canlon B, Hasson D. Emotional Exhaustion as a Predictor of Tinnitus. Psychother Psychosom. 2012;81(5):324–6.
31. Fagelson MA. The Association Between Tinnitus and Posttraumatic Stress Disorder. Am J Audiol. 2007 Dec;16(2):107–17.
32. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hear Res. 2016 Mar;333:255–65.
33. Landry EC, Sandoval XCR, Simeone CN, Tidball G, Lea J, Westerberg BD. Systematic Review and Network Meta-analysis of Cognitive and/or Behavioral Therapies (CBT) for Tinnitus. Otology & Neurotology. 2020 Feb;41(2):153–66.
34. Hesser H, Weise C, Westin VZ, Andersson G. A systematic review and meta-analysis of randomized controlled trials of cognitive–behavioral therapy for tinnitus distress. Clin Psychol Rev. 2011 Jun;31(4):545–53.
35. Andersson G. Psychological aspects of tinnitus and the application of cognitive–behavioral therapy. Clin Psychol Rev. 2002 Sep;22(7):977–90.
36. Rademaker MM, Stegeman I, Ho-Kang-You KE, Stokroos RJ, Smit AL. The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review. Front Neurol. 2019 Nov 1;10.
37. Baldo P, Doree C, Molin P, McFerran D, Cecco S. Antidepressants for patients with tinnitus. Cochrane Database of Systematic Reviews. 2012 Sep 12;2012(9).
38. Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in Patients with Tinnitus: A Systematic Review. Otolaryngology–Head and Neck Surgery. 2019 Jul 26;161(1):28–35.
39. Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol. 2022 May 2;13.
40. Anggraini Y. Depression in Patients with Tinnitus: A Literature Review. Scientia Psychiatrica. 2021 Aug 26;4(2):363–8.
41. Labree B, Hoare DJ, Gascoyne LE, Scutt P, Del Giovane C, Sereda M. Determining the Effects of Transcranial Direct Current Stimulation on Tinnitus, Depression, and Anxiety: A Systematic Review. Brain Sci. 2022 Apr 8;12(4):484.
2. Jarach CM, Lugo A, Scala M, van den Brandt PA, Cederroth CR, Odone A, et al. Global Prevalence and Incidence of Tinnitus. JAMA Neurol. 2022 Sep 1;79(9):888.
3. Hackenberg B, Döge J, O’Brien K, Bohnert A, Lackner KJ, Beutel ME, et al. Tinnitus and Its Relation to Depression, Anxiety, and Stress—A Population-Based Cohort Study. J Clin Med. 2023 Feb 1;12(3):1169.
4. Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: Results from the HUNT Study. J Psychosom Res. 2010 Sep;69(3):289–98.
5. Karoui M, Kchaou A, Amri G, Nefzi H, Kammoun R, Ellouz F. Anxiety, depression and tinnitus: a cross-sectional study about 60 cases. European Psychiatry. 2022 Jun 1;65(S1):S467–S467.
6. Korkut S, Altıntaş M. The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During the
7. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hear Res. 2016 Mar;333:255–65.
8. Karoui M, Kchaou A, Amri G, Nefzi H, Kammoun R, Ellouz F. Anxiety, depression and tinnitus: a cross-sectional study about 60 cases. European Psychiatry. 2022 Jun 1;65(S1):S467–S467.
9. Ooms E, Vanheule S, Meganck R, Vinck B, Watelet JB, Dhooge I. Tinnitus severity and its association with cognitive and somatic anxiety: a critical study. European Archives of Oto-Rhino-Laryngology. 2012 Nov 23;269(11):2327–33.
10. Chen Y, Xia W, Chen H, Feng Y, Xu J, Gu J, et al. Tinnitus distress is linked to enhanced resting‐state functional connectivity from the limbic system to the auditory cortex. Hum Brain Mapp. 2017 May 23;38(5):2384–97.
11. Vanneste S, Plazier M, der Loo E van, de Heyning P Van, Congedo M, De Ridder D. The neural correlates of tinnitus-related distress. Neuroimage. 2010 Aug 15;52(2):470–80.
12. Crocetti A, Forti S, Ambrosetti U, Bo L Del. Questionnaires to evaluate anxiety and depressive levels in tinnitus patients. Otolaryngology–Head and Neck Surgery. 2009 Mar;140(3):403–5.
13. Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in Patients with Tinnitus: A Systematic Review. Otolaryngology–Head and Neck Surgery. 2019 Jul 26;161(1):28–35.
14. Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol. 2022 May 2;13.
15. Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. Tinnitus and depression. The World Journal of Biological Psychiatry. 2011 Oct 13;12(7):489–500.
16. Trevis KJ, McLachlan NM, Wilson SJ. Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention. Front Psychol. 2016 Aug 24;7.
17. Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol. 2022 May 2;13.
18. Joos K, Vanneste S, De Ridder D. Disentangling Depression and Distress Networks in the Tinnitus Brain. PLoS One. 2012 Jul 12;7(7):e40544.
19. Han KM, Ko YH, Shin C, Lee JH, Choi J, Kwon DY, et al. Tinnitus, depression, and suicidal ideation in adults: A nationally representative general population sample. J Psychiatr Res. 2018 Mar;98:124–32.
20. Ooms E, Meganck R, Vanheule S, Vinck B, Watelet J, Dhooge I. Tinnitus Severity and the Relation to Depressive Symptoms. Otolaryngology–Head and Neck Surgery. 2011 Aug 31;145(2):276–81.
21. Niemann U, Brueggemann P, Boecking B, Mazurek B, Spiliopoulou M. Development and internal validation of a depression severity prediction model for tinnitus patients based on questionnaire responses and socio-demographics. Sci Rep. 2020 Mar 13;10(1):4664.
22. Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: Results from the HUNT Study. J Psychosom Res. 2010 Sep;69(3):289–98.
23. Gomaa MAM, Elmagd MHA, Elbadry MM, Kader RMA. Depression, Anxiety and Stress Scale in patients with tinnitus and hearing loss. European Archives of Oto-Rhino-Laryngology. 2014 Aug 27;271(8):2177–84.
24. Chakrabarty S, Mudar R, Chen Y, Husain FT. Contribution of Tinnitus and Hearing Loss to Depression: NHANES Population Study. Ear Hear. 2024 May 31;45(3):775–86.
25. Chen X, Hu K, Song H, Yin L, Kaijser M, Gurholt TP, et al. Depression, anxiety and brain volume after hearing loss and tinnitus: cohort study in the UK Biobank. BJPsych Open. 2024 Mar 1;10(2):e37.
26. Pierzycki RH, Kitterick PT. Insomnia, Anxiety and Depression in Adult Cochlear Implant Users With Tinnitus. Ear Hear. 2021 Jan;42(1):235–43.
27. Crönlein T, Langguth B, Pregler M, Kreuzer PM, Wetter TC, Schecklmann M. Insomnia in patients with chronic tinnitus: Cognitive and emotional distress as moderator variables. J Psychosom Res. 2016 Apr;83:65–8.
28. Richter K, Zimni M, Tomova I, Retzer L, Höfig J, Kellner S, et al. Insomnia Associated with Tinnitus and Gender Differences. Int J Environ Res Public Health. 2021 Mar 19;18(6):3209.
29. Herr RM, Loerbroks A, Bosch JA, Seegel M, Schneider M, Schmidt B. Associations of Organizational Justice with Tinnitus and the Mediating Role of Depressive Symptoms and Burnout—Findings from a Cross-Sectional Study. Int J Behav Med. 2016 Apr 11;23(2):190–7.
30. Hébert S, Canlon B, Hasson D. Emotional Exhaustion as a Predictor of Tinnitus. Psychother Psychosom. 2012;81(5):324–6.
31. Fagelson MA. The Association Between Tinnitus and Posttraumatic Stress Disorder. Am J Audiol. 2007 Dec;16(2):107–17.
32. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hear Res. 2016 Mar;333:255–65.
33. Landry EC, Sandoval XCR, Simeone CN, Tidball G, Lea J, Westerberg BD. Systematic Review and Network Meta-analysis of Cognitive and/or Behavioral Therapies (CBT) for Tinnitus. Otology & Neurotology. 2020 Feb;41(2):153–66.
34. Hesser H, Weise C, Westin VZ, Andersson G. A systematic review and meta-analysis of randomized controlled trials of cognitive–behavioral therapy for tinnitus distress. Clin Psychol Rev. 2011 Jun;31(4):545–53.
35. Andersson G. Psychological aspects of tinnitus and the application of cognitive–behavioral therapy. Clin Psychol Rev. 2002 Sep;22(7):977–90.
36. Rademaker MM, Stegeman I, Ho-Kang-You KE, Stokroos RJ, Smit AL. The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review. Front Neurol. 2019 Nov 1;10.
37. Baldo P, Doree C, Molin P, McFerran D, Cecco S. Antidepressants for patients with tinnitus. Cochrane Database of Systematic Reviews. 2012 Sep 12;2012(9).
38. Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in Patients with Tinnitus: A Systematic Review. Otolaryngology–Head and Neck Surgery. 2019 Jul 26;161(1):28–35.
39. Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol. 2022 May 2;13.
40. Anggraini Y. Depression in Patients with Tinnitus: A Literature Review. Scientia Psychiatrica. 2021 Aug 26;4(2):363–8.
41. Labree B, Hoare DJ, Gascoyne LE, Scutt P, Del Giovane C, Sereda M. Determining the Effects of Transcranial Direct Current Stimulation on Tinnitus, Depression, and Anxiety: A Systematic Review. Brain Sci. 2022 Apr 8;12(4):484.
| Issue | Articles in Press | |
| Section | Review Article(s) | |
| Keywords | ||
| Tinnitus, Anxiety, Depression, Mental Health | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Ali Naji B, Hameed Alnajar A. The Impact of Tinnitus on Mental Health. jmr. 2025;(-).
