Stress-Related Psychological Disorders and Tinnitus

  • Sylvie HébertEmail author
  • Birgit Mazurek
  • Agnieszka J. Szczepek


This contribution highlights the role of stress-related psychological conditions in tinnitus. Relevant psychological disorders such as mood and anxiety disorders are introduced, and their relation with stress is presented. Further, the incidence of psychological disorders among patients with tinnitus is presented and the clinical and therapeutic implications suggested.


Tinnitus Anxiety Depression Psychological disorders Stress 


  1. Adami Dehkordi M, Javanbakht M, Sarfarazi Moghadam S, Meshkat M, Abolbashari S (2015) Personality traits in patients with subjective idiopathic tinnitus. Iran J Otorhinolaryngol 27:369–375PubMedPubMedCentralGoogle Scholar
  2. Andersson G, Hesser H, Cima RF, Weise C (2013) Autobiographical memory specificity in patients with tinnitus versus patients with depression and normal controls. Cogn Behav Ther 42:116–126CrossRefPubMedGoogle Scholar
  3. Anisman H, Merali Z (2003) Cytokines, stress and depressive illness: brain-immune interactions. Ann Med 35:2–11CrossRefPubMedGoogle Scholar
  4. Baigi A, Oden A, Almlid-Larsen V, Barrenas ML, Holgers KM (2011) Tinnitus in the general population with a focus on noise and stress: a public health study. Ear Hear 32:787–789CrossRefPubMedGoogle Scholar
  5. Baldo P, Doree C, Molin P, McFerran D, Cecco S (2012) Antidepressants for patients with tinnitus. Cochrane Database Syst Rev:CD003853. doi: 10.1002/14651858.CD003853.pub3
  6. Bartels H, Middel B, Pedersen SS, Staal MJ, Albers FW (2010a) The distressed (type D) personality is independently associated with tinnitus: a case-control study. Psychosomatics 51:29–38PubMedGoogle Scholar
  7. Bartels H, Pedersen SS, van der Laan BF, Staal MJ, Albers FW, Middel B (2010b) The impact of type D personality on health-related quality of life in tinnitus patients is mainly mediated by anxiety and depression. Otol Neurotol 31:11–18CrossRefPubMedGoogle Scholar
  8. Bauer CA, Berry J, Brozoski TJ (2016) Clinical trials supported by the Tinnitus Research Consortium: lessons learned, the Southern Illinois University experience. Hear Res 334:65–71CrossRefPubMedGoogle Scholar
  9. Bayar N, Oguzturk O, Koc C (2002) Minnesota multiphasic personality inventory profile of patients with subjective tinnitus. J Otolaryngol 31:317–322CrossRefPubMedGoogle Scholar
  10. Carpenter-Thompson JR, Akrofi K, Schmidt SA, Dolcos F, Husain FT (2014) Alterations of the emotional processing system may underlie preserved rapid reaction time in tinnitus. Brain Res 1567:28–41CrossRefPubMedGoogle Scholar
  11. Chang JP, Wu CC (2012) Serotonin-norepinephrine reuptake inhibitor treatment for tinnitus and depression. J Clin Psychopharmacol 32:729CrossRefPubMedGoogle Scholar
  12. Cima RF, Maes IH, Joore MA, Scheyen DJ, El Refaie A, Baguley DM, Anteunis LJ, van Breukelen GJ, Vlaeyen JW (2012) Specialised treatment based on cognitive behaviour therapy versus usual care for tinnitus: a randomised controlled trial. Lancet 379:1951–1959CrossRefPubMedGoogle Scholar
  13. Collet L, Moussu MF, Disant F, Ahami T, Morgon A (1990) Minnesota multiphasic personality inventory in tinnitus disorders. Audiology 29:101–106CrossRefPubMedGoogle Scholar
  14. Demeester K, Topsakal V, Hendrickx JJ, Fransen E, van Laer L, Van Camp G, Van de Heyning P, van Wieringen A (2012) Hearing disability measured by the speech, spatial, and qualities of hearing scale in clinically normal-hearing and hearing-impaired middle-aged persons, and disability screening by means of a reduced ssq (the ssq5). Ear Hear 33:615–616CrossRefPubMedGoogle Scholar
  15. Draugalis JR, Plaza CM (2009) Best practices for survey research reports revisited: implications of target population, probability sampling, and response rate. Am J Pharm Educ 73:142CrossRefPubMedPubMedCentralGoogle Scholar
  16. Fournier P, Hebert S (2013) Gap detection deficits in humans with tinnitus as assessed with the acoustic startle paradigm: does tinnitus fill in the gap? Hear Res 295:16–23CrossRefPubMedGoogle Scholar
  17. Halford JB, Anderson SD (1991) Anxiety and depression in tinnitus sufferers. J Psychosom Res 35:383–390CrossRefPubMedGoogle Scholar
  18. Hasson D, Theorell T, Liljeholm-Johansson Y, Canlon B (2009) Psychosocial and physiological correlates of self-reported hearing problems in male and female musicians in symphony orchestras. Int J Psychophysiol 74:93–100CrossRefPubMedGoogle Scholar
  19. Hasson D, Theorell T, Wallen MB, Leineweber C, Canlon B (2011) Stress and prevalence of hearing problems in the Swedish working population. BMC Public Health 11:130CrossRefPubMedPubMedCentralGoogle Scholar
  20. Hebert S, Lupien SJ (2007) The sound of stress: blunted cortisol reactivity to psychosocial stress in tinnitus sufferers. Neurosci Lett 411:138–142CrossRefPubMedGoogle Scholar
  21. Hebert S, Paiement P, Lupien SJ (2004) A physiological correlate for the intolerance to both internal and external sounds. Hear Res 190:1–9CrossRefPubMedGoogle Scholar
  22. Hebert S, Canlon B, Hasson D (2012a) Emotional exhaustion as a predictor of tinnitus. Psychother Psychosom 81:324–326CrossRefPubMedGoogle Scholar
  23. Hebert S, Canlon B, Hasson D, Magnusson Hanson LL, Westerlund H, Theorell T (2012b) Tinnitus severity is reduced with reduction of depressive mood—a prospective population study in Sweden. PLoS One 7:e37733CrossRefPubMedPubMedCentralGoogle Scholar
  24. Hoskin R, Hunter MD, Woodruff PW (2014) The effect of psychological stress and expectation on auditory perception: a signal detection analysis. Br J Psychol 105:524–546CrossRefPubMedGoogle Scholar
  25. House PR (1981) Personality of the tinnitus patient. Ciba Found Symp 85:193–203PubMedGoogle Scholar
  26. Jastreboff PJ (2007) Tinnitus retraining therapy. Prog Brain Res 166:415–423CrossRefPubMedGoogle Scholar
  27. Jastreboff PJ (2015) 25 years of tinnitus retraining therapy. HNO 63:307–311CrossRefPubMedGoogle Scholar
  28. Kehrle HM, Sampaio AL, Granjeiro RC, de Oliveira TS, Oliveira CA (2016) Tinnitus annoyance in normal-hearing individuals: correlation with depression and anxiety. Ann Otol Rhinol Laryngol 125:185–194CrossRefPubMedGoogle Scholar
  29. Kirk KM, McGuire A, Nasveld PE, Treloar SA (2012) Comparison of self-reported and audiometrically-measured hearing loss in the Australian defence force. Int J Audiol 51:294–298CrossRefPubMedGoogle Scholar
  30. Kubera M, Obuchowicz E, Goehler L, Brzeszcz J, Maes M (2011) In animal models, psychosocial stress-induced (neuro)inflammation, apoptosis and reduced neurogenesis are associated to the onset of depression. Prog Neuropsychopharmacol Biol Psychiatry 35:744–759CrossRefPubMedGoogle Scholar
  31. Langenbach M, Olderog M, Michel O, Albus C, Kohle K (2005) Psychosocial and personality predictors of tinnitus-related distress. Gen Hosp Psychiatry 27:73–77CrossRefPubMedGoogle Scholar
  32. Langguth B, Kleinjung T, Fischer B, Hajak G, Eichhammer P, Sand PG (2007) Tinnitus severity, depression, and the big five personality traits. Prog Brain Res 166:221–225CrossRefPubMedGoogle Scholar
  33. Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G (2011) Tinnitus and depression. World J Biol Psychiatry 12:489–500CrossRefPubMedGoogle Scholar
  34. Lin YH, Chen CY, Lu SY (2009) Physical discomfort and psychosocial job stress among male and female operators at telecommunication call centers in Taiwan. Appl Ergon 40:561–568CrossRefPubMedGoogle Scholar
  35. Liu D, Xiao B, Han F, Wang E, Shi Y (2012) Single-prolonged stress induces apoptosis in dorsal raphe nucleus in the rat model of posttraumatic stress disorder. BMC Psychiatry 12:211CrossRefPubMedPubMedCentralGoogle Scholar
  36. Maes IH, Cima RF, Vlaeyen JW, Anteunis LJ, Joore MA (2013) Tinnitus: a cost study. Ear Hear 34:508–514CrossRefPubMedGoogle Scholar
  37. Maes IH, Cima RF, Anteunis LJ, Scheijen DJ, Baguley DM, El Refaie A, Vlaeyen JW, Joore MA (2014) Cost-effectiveness of specialized treatment based on cognitive behavioral therapy versus usual care for tinnitus. Otol Neurotol 35:787–795CrossRefPubMedGoogle Scholar
  38. Martinez-Devesa P, Perera R, Theodoulou M, Waddell A (2010) Cognitive behavioural therapy for tinnitus. Cochrane Database Syst Rev:CD005233. doi: 10.1002/14651858.CD005233.pub3
  39. Mazurek B, Olze H, Haupt H, Szczepek AJ (2010) The more the worse: the grade of noise-induced hearing loss associates with the severity of tinnitus. Int J Environ Res Public Health 7:3071–3079CrossRefPubMedPubMedCentralGoogle Scholar
  40. Mazurek B, Szczepek AJ, Hebert S (2015) Stress and tinnitus. HNO 63:258–265CrossRefPubMedGoogle Scholar
  41. O’Donovan A, Slavich GM, Epel ES, Neylan TC (2013) Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging. Neurosci Biobehav Rev 37:96–108CrossRefPubMedGoogle Scholar
  42. Oishi N, Kanzaki S, Shinden S, Saito H, Inoue Y, Ogawa K (2010) Effects of selective serotonin reuptake inhibitor on treating tinnitus in patients stratified for presence of depression or anxiety. Audiol Neurootol 15:187–193CrossRefPubMedGoogle Scholar
  43. Oishi N, Shinden S, Kanzaki S, Saito H, Inoue Y, Ogawa K (2011) Influence of depressive symptoms, state anxiety, and pure-tone thresholds on the tinnitus handicap inventory in Japan. Int J Audiol 50:491–495CrossRefPubMedGoogle Scholar
  44. Ooms E, Meganck R, Vanheule S, Vinck B, Watelet JB, Dhooge I (2011) Tinnitus severity and the relation to depressive symptoms: a critical study. Otolaryngol Head Neck Surg 145:276–281CrossRefPubMedGoogle Scholar
  45. Ooms E, Vanheule S, Meganck R, Vinck B, Watelet JB, Dhooge I (2012) Tinnitus severity and its association with cognitive and somatic anxiety: a critical study. Eur Arch Otorhinolaryngol 269:2327–2333CrossRefPubMedGoogle Scholar
  46. Ooms E, Vanheule S, Meganck R, Vinck B, Watelet JB, Dhooge I (2013) Tinnitus, anxiety and automatic processing of affective information: an explorative study. Eur Arch Otorhinolaryngol 270:823–830CrossRefPubMedGoogle Scholar
  47. Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, Sabbe BC (2016) Tinnitus and anxiety disorders: a review. Hear Res 333:255–265CrossRefPubMedGoogle Scholar
  48. Piccirillo JF, Finnell J, Vlahiotis A, Chole RA, Spitznagel E Jr (2007) Relief of idiopathic subjective tinnitus: is gabapentin effective? Arch Otolaryngol Head Neck Surg 133:390–397CrossRefPubMedGoogle Scholar
  49. Rauschecker JP, Leaver AM, Muhlau M (2010) Tuning out the noise: limbic-auditory interactions in tinnitus. Neuron 66:819–826CrossRefPubMedPubMedCentralGoogle Scholar
  50. Robinson SK, Viirre ES, Bailey KA, Gerke MA, Harris JP, Stein MB (2005) Randomized placebo-controlled trial of a selective serotonin reuptake inhibitor in the treatment of nondepressed tinnitus subjects. Psychosom Med 67:981–988CrossRefPubMedGoogle Scholar
  51. Shargorodsky J, Curhan GC, Farwell WR (2010) Prevalence and characteristics of tinnitus among us adults. Am J Med 123:711–718CrossRefPubMedGoogle Scholar
  52. Simoens VL, Hebert S (2012) Cortisol suppression and hearing thresholds in tinnitus after low-dose dexamethasone challenge. BMC Ear Nose Throat Disord 12:4CrossRefPubMedPubMedCentralGoogle Scholar
  53. Slavich GM, O’Donovan A, Epel ES, Kemeny ME (2010) Black sheep get the blues: a psychobiological model of social rejection and depression. Neurosci Biobehav Rev 35:39–45CrossRefPubMedPubMedCentralGoogle Scholar
  54. Stattrop U, Goebel G, Voderholzer U (2013) Correspondence (letter to the editor): the therapeutic objective: reducing the stress caused by tinnitus. Dtsch Arztebl Int 110:599–600PubMedPubMedCentralGoogle Scholar
  55. Swartzman S, Booth JN, Munro A, Sani F (2017) Posttraumatic stress disorder after cancer diagnosis in adults: a meta-analysis. Depress Anxiety 34(4):327–339CrossRefPubMedGoogle Scholar
  56. Tyler RS, Coelho C, Noble W (2006) Tinnitus: standard of care, personality differences, genetic factors. ORL J Otorhinolaryngol Relat Spec 68:14–19; discussion 20–22CrossRefPubMedGoogle Scholar
  57. Wallhausser-Franke E, Delb W, Balkenhol T, Hiller W, Hormann K (2014) Tinnitus-related distress and the personality characteristic resilience. Neural Plast 2014:370307CrossRefPubMedPubMedCentralGoogle Scholar
  58. Weidt S, Delsignore A, Meyer M, Rufer M, Peter N, Drabe N, Kleinjung T (2016) Which tinnitus-related characteristics affect current health-related quality of life and depression? A cross-sectional cohort study. Psychiatry Res 237:114–121CrossRefPubMedGoogle Scholar
  59. Welch D, Dawes PJ (2008) Personality and perception of tinnitus. Ear Hear 29:684–692CrossRefPubMedGoogle Scholar
  60. Yuksel F, Karatas D (2016) Can platelet indices be new biomarkers for subjective tinnitus? J Craniofac Surg 27:e420–e424CrossRefPubMedGoogle Scholar
  61. Zirke N, Seydel C, Arsoy D, Klapp BF, Haupt H, Szczepek AJ, Olze H, Goebel G, Mazurek B (2013a) Analysis of mental disorders in tinnitus patients performed with composite international diagnostic interview. Qual Life Res 22:2095–2104CrossRefPubMedGoogle Scholar
  62. Zirke N, Seydel C, Szczepek AJ, Olze H, Haupt H, Mazurek B (2013b) Psychological comorbidity in patients with chronic tinnitus: analysis and comparison with chronic pain, asthma or atopic dermatitis patients. Qual Life Res 22:263–272CrossRefPubMedGoogle Scholar
  63. Zöger S, Svedlund J, Holgers KM (2001) Psychiatric disorders in tinnitus patients without severe hearing impairment: 24 month follow-up of patients at an audiological clinic. Audiology 40:133–140CrossRefPubMedGoogle Scholar
  64. Zöger S, Svedlund J, Holgers KM (2006) Relationship between tinnitus severity and psychiatric disorders. Psychosomatics 47:282–288CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Sylvie Hébert
    • 1
    Email author
  • Birgit Mazurek
    • 2
  • Agnieszka J. Szczepek
    • 3
  1. 1.School of Speech Pathology and AudiologyUniversité de MontréalMontréalCanada
  2. 2.Tinnitus Center, Charité University HospitalBerlinGermany
  3. 3.Department of Otorhinolaryngology, Head and Neck SurgeryCharité University HospitalBerlinGermany

Personalised recommendations