Parental Mental Health in Childhood as a Risk Factor for Anxiety and Depression among People Seeking Help for Tinnitus and Hyperacusis

J Am Acad Audiol. 2019 Oct;30(9):772-780. doi: 10.3766/jaaa.18001. Epub 2018 Nov 16.


Background: Parental mental illness is a risk factor for mental health disorders in the offspring. However, the relationship between parental illness in childhood and mental health disorders in adulthood among patients with tinnitus and/or hyperacusis is not known.

Purpose: The aim was to explore the relationship between parental mental health in childhood and anxiety and depression for patients experiencing tinnitus and/or hyperacusis.

Research design: This was a retrospective cross-sectional study with a correlational design.

Study sample: Two hundred eighty-seven consecutive patients who attended a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom were included. Their average age was 52.5 years.

Data collection and analysis: The association was explored between anxiety and depression measured via the Generalized Anxiety Disorder questionnaire (GAD-7) and the Patient Health questionnaire (PHQ-9) and responses to the question "While you were growing up during the first 18 years of life did your parent(s) have depression or mental illness?"

Results: Thirty-nine percent of patients (111/287) responded "yes" to the question about their parents' mental health, which is about double the incidence in the general population. Regression analysis showed that parental mental illness significantly increased the risk of anxiety and depression, with unadjusted odds ratios (ORs) of 2.7 (95% confidence interval [CI]: 1.5-4.9, p = 0.001) for the PHQ-9 and 2.6 (95% CI: 1.4-4.8, p = 0.002) for the GAD-7. However, when the models were adjusted for the effects of age, gender, tinnitus handicap as measured via the Tinnitus Handicap Inventory, hyperacusis handicap as measured via the Hyperacusis questionnaire, uncomfortable loudness levels, GAD-7 scores (for the depression model only), and PHQ-9 scores (for the anxiety model only), parental mental health was only significantly associated with depression, with an OR of 2.7 (95% CI: 1.08-6.7, p = 0.033).

Conclusions: Audiologists offering tinnitus and hyperacusis rehabilitation should screen patients for parental mental illness in childhood, especially for those with comorbid depression, and make onward referral to appropriate mental health services when needed. Future research should analyze the breadth and type of adverse childhood experiences among patients with tinnitus and hyperacusis and their relationship with mental problems and treatment efficacy.

MeSH terms

  • Adolescent
  • Adult
  • Adult Children*
  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology*
  • Anxiety / etiology*
  • Correlation of Data
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Depression / etiology*
  • Female
  • Humans
  • Hyperacusis / complications*
  • Male
  • Mental Health*
  • Middle Aged
  • Parents / psychology*
  • Patient Acceptance of Health Care
  • Retrospective Studies
  • Risk Factors
  • Tinnitus / complications*
  • Young Adult