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Major Depressive Disorder Exacerbates Symptoms in Tinnitus Patients
A DGReview of :"Depression and tinnitus"
Otolaryngologic Clinics of North America
08/13/2003
By Jill Taylor
People who are most severely bothered by tinnitus are likely to have major depressive disorder (MDD).
Subjective tinnitus is a relatively common condition in which sound is perceived in the absence of an external acoustic stimulus. While the majority of tinnitus patients are neither depressed nor seriously bothered by their hearing condition, other patients report that tinnitus interferes with activities of daily living, including sleep, reading, social interaction, and concentration, according to Robert A. Dobie, M.D. of the University of California Davis in Sacramento, United States.
In a recently published overview of depression and tinnitus, Dr. Dobie presents information based on his experience with depression in a tinnitus clinic at the University of Washington, where depressed tinnitus patients were found to be far more disabled in everyday life than non-depressed patients with comparable tinnitus severity.
Tinnitus is likely to act as a stressor that triggers psychiatric disorder in predisposed individuals as opposed to being a causative agent.
Approximately half of the depressed patients treated at the University of Washington clinic had MDD prior to the development of tinnitus.
Particularly due to the association between depression and suicide, otolaryngologists should suspect depression in patients reporting five or more MDD symptoms, including a predominantly depressed mood, diminished self worth, lack of interest in daily activities, unexplained weight change, insomnia, psychomotor agitation or retardation, inability to concentrate, or thoughts of death.
For otolaryngologists who choose not to refer patients at risk of MDD to a psychiatrist or primary care physician, Dr. Dobie suggests that tricyclic antidepressant drugs such as nortriptyline and amitriptyline may be useful treatment.
"The goal is not to eliminate tinnitus, but to convert suffering and disabled patients into people who can forget about their tinnitus most of the time," he says.
Otolaryngol Clin North Am 2003 Apr;36:2:383-8.
"Depression and tinnitus"
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