[Psychological changes in tinnitus patients at different disease stages and related factors of comorbid somatic symptoms].

Objective: To investigate the psychological changes in tinnitus patients at different disease stages and associated factors of comorbid somatic symptoms (SS). Methods: This was a cross-sectional study. Tinnitus patients visited the Otolaryngology, Head and Neck Surgery Outpatient Clinic of Peking University People's Hospital between January 2023 and June 2024 were enrolled. Baseline demographic and clinical data were collected, and tinnitus severity as well as psychological status were evaluated for all participants. All patients completed the Tinnitus Handicap Inventory (THI), Somatic Symptom Self-Rating Scale (SSSRS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire 9-item(PHQ-9). Tinnitus characteristics and psychological status were analyzed across patients with different disease courses. Participants were stratified into the SS group (score≥30) and the non-SS group based on SSSRS scores. Multivariate logistic regression analysis was performed to identify factors associated with comorbid SS in tinnitus patients. Results: A total of 691 tinnitus patients aged (44.8±13.1) years were enrolled, including 367 males and 324 females. Among them, 377 patients (54.6%) had chronic tinnitus (>6 months), 265 (38.4%) had comorbid anxiety, 312 (45.2%) had comorbid depression, and 394 (57.0%) had comorbid SS. Compared with the tinnitus patients with a disease duration of ≤3 months and >6 months, those with a disease duration of >3-6 months showed an increasing trend in THI scores, but the difference was not statistically significant (all P>0.017). Multivariate logistic regression analysis revealed that female sex (OR=1.886, 95%CI: 1.267-2.806, P=0.002), THI functional subscale (THI-F) score (OR=1.053, 95%CI: 1.033-1.073, P<0.001), anxiety (OR=2.454, 95%CI: 1.509-3.991, P<0.001), and depression (OR=7.902, 95%CI: 4.886-12.782, P<0.001) were independent associated factors for comorbid SS in tinnitus patients. Conclusions: Most tinnitus patients suffer from chronic tinnitus and are prone to comorbid psychological problems. Compared with the group with a disease duration of ≤3 months and >6 months, patients with a tinnitus duration of >3-6 months show an increasing trend in THI scores. Female gender, THI-F score, anxiety, and depression are associated factors for comorbid SS in tinnitus patients.