The Role of Psychological Factors in Tinnitus

Tinnitus is usually perceived as a continuous buzzing, hissing or ringing sound in the ears [1]. Subjective tinnitus, the most common form of tinnitus is only perceived to a tinnitus patient and there is no corresponding sound source. On the contrary, the perceived noise has its source within a patient’s body in objective tinnitus cases. About 90% of all tinnitus cases are accompanied by hearing loss [2] which is a risk factor of tinnitus [3]. Even though it is a fact that tinnitus has a high prevalence and results in disturbances, researchers assume that the mechanism to develop and maintain tinnitus is not fully understood [4]. Previous research showed that 35-45% of adults have subjective tinnitus at some point in their life [5], 8-15% of adults suffer from tinnitus [6], and 18% of people in industrialized societies are mildly affected by chronic tinnitus [7]. However, it is not clear what the factors are for onset, persistence, severity, and adverse effect of tinnitus. There had been some biomedical models explaining the relation between tinnitus and a physiological mechanism, neurological mechanism, and immunological mechanism, which were supported by some empirical studies. These models showed limitations to find out the cause and result of tinnitus, and since then, more attention has been paid to other factors beyond the biomedical models. One of the most popular factors was personalities or psychological aspects. This review will deal with psychological factors related to tinnitus through the empirical studies done so far and discuss the direction of future studies on personality factors. Before reviewing the relation between tinnitus and personality aspects further, the issue of psychiatric disorders needs to be addressed. Knowing the effects of psychiatric disorders on tinnitus is helpful to understand neurological causes of tinnitus as well as to find out the neurological changes caused by tinnitus because psychiatric disorders include the physical mechanism. It is also helpful to understand the personality or temperament factors since psychiatric disorders embrace the psychological explanation of tinnitus. Hanyang Med Rev 2016;36:92-98 http://dx.doi.org/10.7599/hmr.2016.36.2.92 pISSN 1738-429X eISSN 2234-4446