The Tinnitus Handicap Inventory as a screening test for psychiatric comorbidity in patients with tinnitus

Psychosomatics. 2013 May-Jun;54(3):248-56. doi: 10.1016/j.psym.2012.05.007. Epub 2012 Dec 7.

Abstract

Background: Psychiatric comorbidity is common in patients who seek help for tinnitus. The perceived severity of tinnitus correlates closer to psychological and general health factors than to audiometrical parameters. Audiologists need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting. The tinnitus handicap inventory (THI) has gained widespread acceptance as a self-report measure of tinnitus handicap. In several studies, THI test score correlates with the level of psychopathologic distress. The aim of our study was to investigate the predictive power of the test THI in relation to psychiatric disorders.

Methods: We recruited 156 patients with chronic tinnitus who have requested help at our tinnitus center. All patients underwent psychiatric evaluation, the diagnosis was made in agreement with the DSMIV-TR criteria; all patients filled out the following questionnaires: THI, Symptomatic Check List-90-Revised (SCL-90-R) and Stress-related Vulnerability Scale (VRS). Sensibility and specificity of tests as screening tool for psychiatric disorders was evaluated using Receiver Operating Characteristic (ROC) curve.

Results: Sixty-eight patients (prevalence: 43.59%) were found to be affected by a psychiatric disorder. AUC = 0.792 (p > 0.001) shows that THI is a moderately accurate test to individuate psychiatric affected people among our sample. We identified a score of 36 at THI (sensibility = 86.76%; specificity = 59.09%) as an appropriate cut-off point.

Conclusions: If a patient reports a THI score greater than 36, the audiologist should supplement diagnostic studies with a psychiatric evaluation.

Publication types

  • Validation Study

MeSH terms

  • Adaptation, Psychological
  • Catastrophization / psychology
  • Chronic Disease
  • Comorbidity
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Mass Screening / standards*
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Personality Inventory / statistics & numerical data
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Quality of Life
  • Tinnitus / epidemiology*
  • Tinnitus / physiopathology
  • Tinnitus / psychology