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J Am Acad Audiol 2019; 30(09): 772-780
DOI: 10.3766/jaaa.18001
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Hashir Aazh
*   Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, United Kingdom
,
Ali A. Danesh
†   Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, FL
,
Brian C. J. Moore
‡   Department of Experimental Psychology, University of Cambridge, Cambridge, United Kingdom
› Author Affiliations
Further Information

Publication History

05 June 2018

18 June 2018

Publication Date:
25 May 2020 (online)

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Abstract

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.

Key Words

adverse childhood experiences - hyperacusis - parental mental health - parental separation - tinnitus
 

  • REFERENCES

  • Aazh H, Allott R. 2016; Cognitive behavioural therapy in management of hyperacusis: a narrative review and clinical implementation. Aud Vest Res 25: 63-74
    Google Scholar
  • Aazh H, Langguth B, Danesh AA. 2018; Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis. Int J Audiol 57 (12) 941-946
    PubMedGoogle Scholar
  • Aazh H, McFerran D, Salvi R, Prasher D, Jastreboff M, Jastreboff M. 2014; Insights from the first international conference on hyperacusis: causes, evaluation, diagnosis and treatment. Noise Health 16: 123-126
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2016; A comparison between tinnitus retraining therapy and a simplified version in treatment of tinnitus in adults. Aud Vest Res 25: 14-23
    Google Scholar
  • Aazh H, Moore BCJ. 2017; a Factors associated with depression in patients with tinnitus and hyperacusis. Am J Audiol 26: 562-569
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2017; b Factors related to Uncomfortable Loudness Levels for patients seen in a tinnitus and hyperacusis clinic. Int J Audiol 56: 793-800
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2017; c Incidence of discomfort during pure-tone audiometry and measurement of uncomfortable loudness levels among people seeking help for tinnitus and/or hyperacusis. Am J Audiol 26: 226-232
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2017; d Usefulness of self-report questionnaires for psychological assessment of patients with tinnitus and hyperacusis and patients’ views of the questionnaires. Int J Audiol 56: 489-498
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2018; a Effectiveness of audiologist-delivered cognitive behavioral therapy for tinnitus and hyperacusis rehabilitation: outcomes for patients treated in routine practice. Am J Audiol 27 (04) 547-558
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2018; b Prevalence and characteristics of patients with severe hyperacusis among patients seen in a tinnitus and hyperacusis clinic. J Am Acad Audiol 29: 626-633
    Article in Thieme ConnectPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2018; c Proportion and characteristics of patients who were offered, enrolled in and completed audiologist-delivered cognitive behavioural therapy for tinnitus and hyperacusis rehabilitation in a specialist UK clinic. Int J Audiol 57: 415-425
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ. 2018; d Thoughts about suicide and self-harm in patients with tinnitus and hyperacusis. J Am Acad Audiol 29: 255-261
    Article in Thieme ConnectPubMedGoogle Scholar
  • Aazh H, Moore BCJ, Glasberg BR. 2008; Simplified form of tinnitus retraining therapy in adults: a retrospective study. BMC Ear Nose Throat Disord 8: 1-7
    CrossrefPubMedGoogle Scholar
  • Aazh H, Moore BCJ, Lammaing K, Cropley M. 2016; Tinnitus and hyperacusis therapy in a UK national health service audiology department: patients’ evaluations of the effectiveness of treatments. Int J Audiol 55: 514-522
    CrossrefPubMedGoogle Scholar
  • Alcala HE, Tomiyama AJ, von Ehrenstein OS. 2017; Gender differences in the association between adverse childhood experiences and cancer. Womens Health Issues 27: 625-631
    CrossrefPubMedGoogle Scholar
  • Anda R, Tietjen G, Schulman E, Felitti V, Croft J. 2010; Adverse childhood experiences and frequent headaches in adults. Headache 50: 1473-1481
    CrossrefPubMedGoogle Scholar
  • Anda RF, Brown DW, Dube SR, Bremner JD, Felitti VJ, Giles WH. 2008; Adverse childhood experiences and chronic obstructive pulmonary disease in adults. Am J Prev Med 34: 396-403
    CrossrefPubMedGoogle Scholar
  • Anda RF, Brown DW, Felitti VJ, Bremner JD, Dube SR, Giles WH. 2007; Adverse childhood experiences and prescribed psychotropic medications in adults. Am J Prev Med 32: 389-394
    CrossrefPubMedGoogle Scholar
  • Anda RF, Dong M, Brown DW, Felitti VJ, Giles WH, Perry GS, Valerie EJ, Dube SR. 2009; The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health 9: 106
    CrossrefPubMedGoogle Scholar
  • Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH. 2006; The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatr Clin Neurosci 256: 174-186
    Google Scholar
  • Andersson G, Carlbring P, Kaldo V, Strom L. 2004; Screening of psychiatric disorders via the Internet. A pilot study with tinnitus patients. Nord J Psychiatry 58: 287-291
    CrossrefPubMedGoogle Scholar
  • Beesdo-Baum K, Knappe S. 2012; Developmental epidemiology of anxiety disorders. Child Adolesc Psychiatr Clin N Am 21: 457-478
    CrossrefPubMedGoogle Scholar
  • Beesdo-Baum K, Knappe S, Asselmann E, Zimmermann P, Bruckl T, Höfler M, Behrendt S, Lieb R, Wittchen HU. 2015; The ‘Early Developmental Stages of Psychopathology (EDSP) study’: a 20-year review of methods and findings. Soc Psychiatry Psychiatr Epidemiol 50: 851-866
    CrossrefPubMedGoogle Scholar
  • Bohman H, Laftman SB, Paaren A, Jonsson U. 2017; Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years. BMC Psychiatry 17: 117
    CrossrefPubMedGoogle Scholar
  • BSA 2011. a Pure-Tone Air-Conduction and Bone-Conduction Threshold Audiometry with and without Masking: Recommended Procedure. Reading, United Kingdom: British Society of Audiology;
    Google Scholar
  • BSA 2011. b Recommended Procedure: Determination of Uncomfortable Loudness Levels. Reading, United Kingdom: British Society of Audiology;
    Google Scholar
  • Chapman DP, Liu Y, Presley-Cantrell LR, Edwards VJ, Wheaton AG, Perry GS, Croft JB. 2013; Adverse childhood experiences and frequent insufficient sleep in 5 U.S. States, 2009: a retrospective cohort study. BMC Public Health 13: 1-9
    CrossrefPubMedGoogle Scholar
  • Dong M, Giles WH, Felitti VJ, Dube SR, Williams JE, Chapman DP, Anda RF. 2004; Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation 110: 1761-1766
    CrossrefPubMedGoogle Scholar
  • Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH. 2001; Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the adverse childhood experiences study. JAMA 286: 3089-3096
    CrossrefPubMedGoogle Scholar
  • Dube SR, Williamson DF, Thompson T, Felitti VJ, Anda RF. 2004; Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse Negl 28: 729-737
    CrossrefPubMedGoogle Scholar
  • Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. 1998; Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. Am J Prev Med 14: 245-258
    CrossrefPubMedGoogle Scholar
  • Henry JA, Frederick M, Sell S, Griest S, Abrams H. 2015; Validation of a novel combination hearing aid and tinnitus therapy device. Ear Hear 36: 42-52
    CrossrefPubMedGoogle Scholar
  • Hesser H, Weise C, Westin VZ, Andersson G. 2011; A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress. Clin Psychol Rev 31: 545-553
    CrossrefPubMedGoogle Scholar
  • Hinz A, Mehnert A, Kocalevent RD, Brahler E, Forkmann T, Singer S, Schulte T. 2016; Assessment of depression severity with the PHQ-9 in cancer patients and in the general population. BMC Psychiatry 16: 22
    CrossrefPubMedGoogle Scholar
  • IAPT 2011. IAPT Data Handbook v2.0.1 Appendices. London, United Kingdom: National IAPT Programme Team;
    Google Scholar
  • Jastreboff PJ, Jastreboff MM. 2003; Tinnitus retraining therapy for patients with tinnitus and decreased sound tolerance. Otolaryngol Clin North Am 36: 321-336
    CrossrefPubMedGoogle Scholar
  • Jones TM, Nurius P, Song C, Fleming CM. 2018; Modeling life course pathways from adverse childhood experiences to adult mental health. Child Abuse Negl 80: 32-40
    CrossrefPubMedGoogle Scholar
  • Juris L, Andersson G, Larsen HC, Ekselius L. 2013; Psychiatric comorbidity and personality traits in patients with hyperacusis. Int J Audiol 52: 230-235
    CrossrefPubMedGoogle Scholar
  • Kajeepeta S, Gelaye B, Jackson CL, Williams MA. 2015; Adverse childhood experiences are associated with adult sleep disorders: a systematic review. Sleep Med 16: 320-330
    CrossrefPubMedGoogle Scholar
  • Khalfa S, Dubal S, Veuillet E, Perez-Diaz F, Jouvent R, Collet L. 2002; Psychometric normalization of a hyperacusis questionnaire. ORL J Otorhinolaryngol Relat Spec 64: 436-442
    CrossrefPubMedGoogle Scholar
  • Kroenke K, Spitzer RL, Williams JB. 2001; The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16: 606-613
    CrossrefPubMedGoogle Scholar
  • Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. 2011; Tinnitus and depression. World J Biol Psychiatry 12: 489-500
    CrossrefPubMedGoogle Scholar
  • Lee RD, Chen J. 2017; Adverse childhood experiences, mental health, and excessive alcohol use: examination of race/ethnicity and sex differences. Child Abuse Negl 69: 40-48
    CrossrefPubMedGoogle Scholar
  • Lowe B, Decker O, Muller S, Brahler E, Schellberg D, Herzog W, Herzberg PY. 2008; Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care 46: 266-274
    CrossrefPubMedGoogle Scholar
  • Newman CW, Jacobson GP, Spitzer JB. 1996; Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg 122: 143-148
    CrossrefPubMedGoogle Scholar
  • Newman CW, Sandridge SA, Jacobson GP. 1998; Psychometric adequacy of the tinnitus handicap inventory (THI) for evaluating treatment outcome. J Am Acad Audiol 9: 153-160
    PubMedGoogle Scholar
  • Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, Sabbe BCG. 2016; Tinnitus and anxiety disorders: a review. Hear Res 333: 255-265
    CrossrefPubMedGoogle Scholar
  • Paulin J, Andersson L, Nordin S. 2016; Characteristics of hyperacusis in the general population. Noise Health 18: 178-184
    CrossrefPubMedGoogle Scholar
  • Pigeon WR, May PE, Perlis ML, Ward EA, Lu N, Talbot NL. 2009; The effect of interpersonal psychotherapy for depression on insomnia symptoms in a cohort of women with sexual abuse histories. J Trauma Stress 22: 634-638
    PubMedGoogle Scholar
  • Pinto PC, Marcelos CM, Mezzasalma MA, Osterne FJ, de Melo Tavares de Lima MA, Nardi AE. 2014; Tinnitus and its association with psychiatric disorders: systematic review. J Laryngol Otol 128: 660-664
    CrossrefPubMedGoogle Scholar
  • Schecklmann M, Landgrebe M, Langguth B. TRI Database Study Group 2014; Phenotypic characteristics of hyperacusis in tinnitus. PLoS One 9: e86944
    CrossrefPubMedGoogle Scholar
  • Spitzer RL, Kroenke K, Williams JB, Lowe B. 2006; A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166: 1092-1097
    CrossrefPubMedGoogle Scholar
  • Tyler RS, Stouffer JL, Schum R. 1989; Audiological rehabilitation of the tinnitus client. J Acad Rehabil Audiol 22: 30-42
    Google Scholar
  • Zigmond AS, Snaith RP. 1983; The hospital anxiety and depression scale. Acta Psychiatr Scand 67: 361-370
    CrossrefPubMedGoogle Scholar