The Impact of Tinnitus on Mental Health
Abstract
Introduction: Tinnitus—the perception of sound in the absence of an external stimulus—affects approximately 14.4% of adults worldwide and significantly impacts mental health. It is frequently associated with anxiety, depression, and cognitive dysfunction, leading to a reduced quality of life (QoL). Tinnitus may be classified as subjective or objective, with severity and related psychological distress varying considerably among individuals.
Materials and Methods: A comprehensive review of literature published between 2010 and 2024 was conducted using databases including 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 examining the psychological impact of tinnitus.
Results: Research consistently indicates that individuals with tinnitus experience varying prevalence rates of anxiety and depression, ranging from 18.5% to 48.33% for anxiety and from 6% to 84% for depression. Shared neural circuits—including the anterior cingulate cortex, insula, and amygdala—are implicated in both tinnitus and mental health conditions. Psychological interventions such as cognitive behavioral therapy (CBT) and mindfulness-based interventions (MBIs) have demonstrated effectiveness in alleviating tinnitus-related distress and enhancing mental well-being.
Conclusion: Tinnitus significantly affects mental health, contributing to anxiety, depression, and sleep disturbances. A multidisciplinary treatment approach that addresses both auditory and psychological dimensions of tinnitus is essential for effective management. Further research is warranted to refine therapeutic strategies and better understand the complex relationship between tinnitus and mental health.
Dubey KK. Tinnitus: Our current understanding. European Journal of Clinical Medicine. 2021; 2(3):1-4. [DOI:10.24018/clinicmed.2021.2.3.26]
Jarach CM, Lugo A, Scala M, van den Brandt PA, Cederroth CR, Odone A, et al. Global prevalence and incidence of tinnitus: A systematic review and meta-analysis. JAMA Neurology. 2022; 79(9):888-900. [DOI:10.1001/jamaneurol.2022.2189] [PMID]
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. Journal of Clinical Medicine. 2023; 12(3):1169. [DOI:10.3390/jcm12031169] [PMID]
Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: Results from the HUNT Study. Journal of Psychosomatic Research. 2010; 69(3):289-98. [DOI:10.1016/j.jpsychores.2010.03.008] [PMID]
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; 65(S1):S467. [DOI:10.1192/j.eurpsy.2022.1186]
Korkut S, Altıntaş M. The frequency of health anxiety, coronavirus anxiety and anxiety disorder in patients with tinnitus during the COVID-19 pandemic and the impact of pandemic on tinnitus. Clinical Otolaryngology. 2024; 49(6):725-32. [DOI:10.1111/coa.14196] [PMID]
Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: A review. Hearing Research. 2016; 333:255-65. [DOI:10.1016/j.heares.2015.08.014] [PMID]
Chen X, Ren L, Xue X, Yu N, Liu P, Shen W, et al. The comorbidity of depression and anxiety symptoms in tinnitus sufferers: A network analysis. Brain Sciences. 2023; 13(4):583. [DOI:10.3390/brainsci13040583]
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; 269(11):2327-33. [DOI:10.1007/s00405-011-1887-1] [PMID]
Chen YC, Xia W, Chen H, Feng Y, Xu JJ, Gu JP, et al. Tinnitus distress is linked to enhanced resting-state functional connectivity from the limbic system to the auditory cortex. Human Brain Mapping. 2017; 38(5):2384-97. [DOI:10.1002/hbm.23525] [PMID]
Vanneste S, Plazier M, der Loo Ev, de Heyning PV, Congedo M, De Ridder D. The neural correlates of tinnitus-related distress. Neuroimage. 2010; 52(2):470-80. [DOI:10.1016/j.neuroimage.2010.04.029] [PMID]
Crocetti A, Forti S, Ambrosetti U, Bo LD. Questionnaires to evaluate anxiety and depressive levels in tinnitus patients. Otolaryngology--Head and Neck Surgery. 2009; 140(3):403-5. [DOI:10.1016/j.otohns.2008.11.036] [PMID]
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; 161(1):28-35. [DOI:10.1177/0194599819835178] [PMID]
Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation between chronic tinnitus distress and symptoms of depression: A systematic review. Frontiers in Neurology. 2022; 13:870433. [DOI:10.3389/fneur.2022.870433] [PMID]
Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. Tinnitus and depression. The World Journal of Biological Psychiatry. 2011; 12(7):489-500. [DOI:10.3109/15622975.2011.575178] [PMID]
Trevis KJ, McLachlan NM, Wilson SJ. Cognitive mechanisms in chronic tinnitus: Psychological markers of a failure to switch attention. Frontiers in Psychology. 2016; 7:1262. [DOI:10.3389/fpsyg.2016.01262] [PMID]
Lin HC, Xirasagar S, Wang CH, Cheng YF, Yang TH. Increased risk of major depressive disorder following tinnitus: A population-based study. Frontiers in Neurology. 2022; 13:836842. [DOI:10.3389/fneur.2022.836842]
Joos K, Vanneste S, De Ridder D. Disentangling depression and distress networks in the tinnitus brain. Plos One. 2012; 7(7):e40544. [DOI:10.1371/journal.pone.0040544] [PMID]
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. Journal of Psychiatric Research. 2018; 98:124-32. [DOI:10.1016/j.jpsychires.2018.01.003] [PMID]
Ooms E, Meganck R, Vanheule S, Vinck B, Watelet JB, Dhooge I. Tinnitus severity and the relation to depressive symptoms: A critical study. Otolaryngology--Head and Neck Surgery. 2011; 145(2):276-81. [DOI:10.1177/0194599811403381] [PMID]
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. Scientific Reports. 2020; 10(1):4664. [DOI:10.1038/s41598-020-61593-z] [PMID]
Gomaa MA, Elmagd MH, Elbadry MM, Kader RM. Depression, anxiety and stress scale in patients with tinnitus and hearing loss. European Archives of Oto-Rhino-Laryngology. 2014; 271(8):2177-84. [DOI:10.1007/s00405-013-2715-6] [PMID]
Chakrabarty S, Mudar R, Chen Y, Husain FT. Contribution of tinnitus and hearing loss to depression: NHANES Population Study. Ear and Hearing. 2024; 45(3):775-86. [DOI:10.1097/AUD.0000000000001467] [PMID]
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; 10(2):e37. [DOI:10.1192/bjo.2023.634] [PMID]
Pierzycki RH, Kitterick PT. Insomnia, anxiety and depression in adult cochlear implant users with tinnitus. Ear and Hearing. 2021; 42(1):235-43. [DOI:10.1097/AUD.0000000000000900] [PMID]
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. Journal of Psychosomatic Research. 2016; 83:65-8. [DOI:10.1016/j.jpsychores.2016.03.001] [PMID]
Richter K, Zimni M, Tomova I, Retzer L, Höfig J, Kellner S, et al. Insomnia associated with tinnitus and gender differences. International Journal of Environmental Research and Public Health. 2021; 18(6):3209. [DOI:10.3390/ijerph18063209] [PMID]
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. International Journal of Behavioral Medicine. 2016; 23(2):190-7. [DOI:10.1007/s12529-015-9505-z] [PMID]
Hébert S, Canlon B, Hasson D. Emotional exhaustion as a predictor of tinnitus. Psychotherapy and Psychosomatics. 2012; 81(5):324-6. [DOI:10.1159/000335043] [PMID]
Fagelson MA. The association between tinnitus and posttraumatic stress disorder. American Journal of Audiology. 2007; 16(2):107-17. [DOI:10.1044/1059-0889(2007/015)] [PMID]
Hou SJ, Yang AC, Tsai SJ, Shen CC, Lan TH. Tinnitus among patients with anxiety disorder: A nationwide longitudinal study. Frontiers in Psychiatry. 2020; 11:606.DOI:10.3389/fpsyt.2020.00606]
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; 41(2):153-66. [DOI:10.1097/MAO.0000000000002472] [PMID]
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. Clinical Psychology Review. 2011; 31(4):545-53. [DOI:10.1016/j.cpr.2010.12.006] [PMID]
Andersson G. Psychological aspects of tinnitus and the application of cognitive-behavioral therapy. Clinical Psychology Review. 2002; 22(7):977-90. [DOI:10.1016/S0272-7358(01)00124-6] [PMID]
Rademaker MM, Stegeman I, Ho-Kang-You KE, Stokroos RJ, Smit AL. The effect of mindfulness-based interventions on tinnitus distress. A systematic review. Frontiers in Neurology. 2019; 10:1135. [DOI:10.3389/fneur.2019.01135] [PMID]
Baldo P, Doree C, Molin P, McFerran D, Cecco S. Antidepressants for patients with tinnitus. The Cochrane Database of Systematic Reviews. 2012; 2012(9):CD003853. [DOI:10.1002/14651858.CD003853.pub3] [PMID]
Lin X, Liu Y, Chen Z, Wei Y, Lin J, Chen C, et al. Association between depression and tinnitus in US adults: A nationally representative sample. Laryngoscope Investigative Otolaryngology. 2023; 8(5):1365-75. [DOI:10.1002/lio2.1134]
Jiang Y, Liu Q, Ding Y, Sun Y. Systematic review and meta-analysis of the correlation between tinnitus and mental health. American Journal of Otolaryngology. 2025; 46(3):104611. [DOI:10.1016/j.amjoto.2025.104611]
Anggraini Y. Depression in patients with tinnitus: A literature review. Scientia Psychiatrica. 2021; 4(2):363-8. [DOI:10.37275/scipsy.v4i2.94]
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 Sciences. 2022; 12(4):484. [DOI:10.3390/brainsci12040484] [PMID]
| Issue | Vol 19 No 4 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/jmr.v19i4.19767 | |
| Keywords | ||
| Tinnitus Anxiety Depression Mental health | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |

