Hostname: page-component-669899f699-b58lm Total loading time: 0 Render date: 2025-04-27T17:22:46.792Z Has data issue: false hasContentIssue false
  • English
  • Français

Suicidal ideation in people with tinnitus: a systematic review and meta-analysis

Published online by Cambridge University Press:  25 October 2021

B V Tailor ,
R E Thompson ,
I Nunney ,
M Agius  and
J S Phillips
B V Tailor*
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norwich
R E Thompson
Affiliation:
School of Clinical Medicine, University of Cambridge
I Nunney
Affiliation:
Norwich Clinical Trials Unit, Norwich Medical School, University of East Anglia,
M Agius
Affiliation:
Center for Mental Health Research in Association with the University of Cambridge, Cambridge, UK
J S Phillips
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital National Health Service Foundation Trust, Norwich
*
Author for correspondence: Dr B V Tailor, Department of Otolaryngology, Norfolk and Norwich University Hospital, Colney Lane, NorwichNR4 7UY, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Tinnitus is associated with a variety of cognitive, psychosocial and psychiatric disorders, and may contribute to suicidality. However, the prevalence of suicidal ideation (SI) in tinnitus populations has not previously been systematically reviewed.

Method

Medline, Embase and PsychInfo were searched in August 2020 to identify studies that assessed suicidal ideation in people aged 16 years and above with subjective tinnitus.

Results

Six cross-sectional studies were included, representing 7192 tinnitus sufferers across 4 countries. The pooled prevalence of suicidal ideation in tinnitus populations was 20.6 per cent (95 per cent confidence interval, 10.8–30.3 per cent; I2 = 88 per cent). Two studies included a control population, in which the prevalence of suicidal ideation was significantly lower. The quality of included studies was variable.

Conclusion

It is not possible to arrive at any reasonable conclusion given the lack of quality studies, meaning the pooled prevalence should be interpreted very cautiously. Suicidal ideation may be more prevalent in tinnitus populations. Further large-scale epidemiological research investigating this relationship is needed, which may help psychiatric risk stratification.

Keywords

TinnitusSuicideSuicidal IdeationPrevalence
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 12 , December 2021 , pp. 1042 - 1050
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Dr B V Tailor takes responsibility for the integrity of the content of the paper

Presented at Student and Foundation Doctors in Otolaryngology Conference, 12 October 2019, Birmingham, UK, and as a poster at Inner Ear Anatomy and the Matthew Yung short paper prize meeting, The Royal Society of Medicine, 7 February 2020, London, UK.

References

Jalessi, M, Farhadi, M, Asghari, A, Kamrava, SK, Amintehran, E, Ghalehbaghi, S et al. Tinnitus: an epidemiologic study in Iranian population. Acta Med Iran 2013;51:886–91Google ScholarPubMed
Park, KH, Lee, SH, Koo, J-W, Park, HY, Lee, KY, Choi, YS et al. Prevalence and associated factors of tinnitus: data from the Korean National Health and Nutrition Examination Survey 2009–2011. J Epidemiol 2014;24:417–26CrossRefGoogle ScholarPubMed
Khedr, EM, Ahmed, MA, Shawky, OA, Mohamed, ES, El Attar, GS, Mohammad, KA. Epidemiological study of chronic tinnitus in Assiut, Egypt. Neuroepidemiology 2010;35:45–5210.1159/000306630CrossRefGoogle ScholarPubMed
Sindhusake, D, Mitchell, P, Newall, P, Golding, M, Rochtchina, E, Rubin, G. Prevalence and characteristics of tinnitus in older adults: the Blue Mountains Hearing Study. Int J Audiol 2003;42:289–94CrossRefGoogle ScholarPubMed
McCormack, A, Edmondson-Jones, M, Somerset, S, Hall, D. A systematic review of the reporting of tinnitus prevalence and severity. Hear Res 2016;337:70–9CrossRefGoogle ScholarPubMed
Holgers, K-M. Tinnitus treatment is guided by etiology. Noise, stress or anxiety/depression plausible causes. Lakartidningen 2003;100:3744–9Google ScholarPubMed
Fackrell, K, Hall, DA, Barry, JG, Hoare, DJ. Performance of the Tinnitus Functional Index as a diagnostic instrument in a UK clinical population. Hear Res 2018;358:74–8510.1016/j.heares.2017.10.016CrossRefGoogle Scholar
Meikle, MB, Henry, JA, Griest, SE, Stewart, BJ, Abrams, HB, McArdle, R et al. The tinnitus functional index: development of a new clinical measure for chronic, intrusive tinnitus. Ear Hear 2012;33:153–76CrossRefGoogle ScholarPubMed
Fackrell, F, Hall, DA, Barry, JG, Hoare, DJ. Tools for tinnitus measurement: development and validity of questionnaires to assess handicap and treatment effects. In: Tinnitus: Causes, Treatment and Short & Long-Term Health Effects. New York: Nova Science Publishers, 2014;13–60Google Scholar
Hiller, W, Goebel, G. Factors influencing tinnitus loudness and annoyance. Arch Otolaryngol Head Neck Surg 2006;132:1323–30CrossRefGoogle ScholarPubMed
Lynn, SG, Bauch, CD, Williams, DE, Beatty, CW, Mellon, MW, Weaver, AL. Psychologic profile of tinnitus patients using the SCL-90-R and Tinnitus Handicap Inventory. Otol Neurotol 2003;24:878–8110.1097/00129492-200311000-00009CrossRefGoogle ScholarPubMed
Reynolds, P, Gardner, D, Lee, R. Tinnitus and psychological morbidity: a cross-sectional study to investigate psychological morbidity in tinnitus patients and its relationship with severity of symptoms and illness perceptions. Clin Otolaryngol Allied Sci 2004;29:628–34CrossRefGoogle ScholarPubMed
Tegg-Quinn, S, Bennett, RJ, Eikelboom, RH, Baguley, DM. The impact of tinnitus upon cognition in adults: a systematic review. Int J Audiol 2016;55:533–40CrossRefGoogle ScholarPubMed
Pinto, PCL, Marcelos, CM, Mezzasalma, MA, Osterne, FJV, de Melo Tavares de Lima, MA, Nardi, AE. Tinnitus and its association with psychiatric disorders: systematic review. J Laryngol Otol 2014;128:660–4CrossRefGoogle ScholarPubMed
Gül, AI, Özkırış, M, Aydin, R, Şimşek, G, Saydam, L. Coexistence of anxiety sensitivity and psychiatric comorbidities in patients with chronic tinnitus. Neuropsychiatr Dis Treat 2015;11:413–8CrossRefGoogle ScholarPubMed
Malakouti, S, Mahmoudian, M, Alifattahi, N, Salehi, M. Comorbidity of chronic tinnitus and mental disorders. Int Tinnitus J 2011;16:118–22Google ScholarPubMed
Pridmore, S, Walter, G, Friedland, P. Tinnitus and suicide: recent cases on the public record give cause for reconsideration. Otolaryngol Neck Surg 2012;147:193–5CrossRefGoogle ScholarPubMed
Frankenburg, FR, Hegarty, JD. Tinnitus, psychosis, and suicide. Arch Intern Med 1994;154:2371–510.1001/archinte.1994.00420200127015CrossRefGoogle ScholarPubMed
Johnston, M, Walker, M. Suicide in the elderly. Recognizing the signs. Gen Hosp Psychiatry 1996;18:257–60CrossRefGoogle ScholarPubMed
Lewis, JE, Stephens, SD, McKenna, L. Tinnitus and suicide. Clin Otolaryngol Allied Sci 1994;19:50–410.1111/j.1365-2273.1994.tb01147.xCrossRefGoogle ScholarPubMed
Jacobson, GP, McCaslin, DL. A search for evidence of a direct relationship between tinnitus and suicide. J Am Acad Audiol 2001;12:493–6Google ScholarPubMed
Posner, K, Oquendo, MA, Gould, M, Stanley, B, Davies, M. Columbia Classification Algorithm of Suicide Assessment (C-CASA): classification of suicidal events in the FDA's pediatric suicidal risk analysis of antidepressants. Am J Psychiatry 2007;164:1035–43CrossRefGoogle ScholarPubMed
Tailor, B, Thompson, R, Nunney, I, Agius, M, Phillips, J. Suicidal ideation in patients with tinnitus: a systematic review. PROSPERO 2020;CRD42020165033CrossRefGoogle Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009;6:e100009710.1371/journal.pmed.1000097CrossRefGoogle ScholarPubMed
Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 2000;283:2008–1210.1001/jama.283.15.2008CrossRefGoogle ScholarPubMed
Bachmann, S. Epidemiology of suicide and the psychiatric perspective. Int J Environ Res Public Health 2018;15:1–2310.3390/ijerph15071425CrossRefGoogle ScholarPubMed
Ouzzani, M, Hammady, H, Fedorowicz, Z, Elmagarmid, A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016;5:210CrossRefGoogle ScholarPubMed
Herzog, R, Álvarez-Pasquin, MJ, Díaz, C, Del Barrio, JL, Estrada, JM, Gil, Á. Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Public Health 2013;13:15410.1186/1471-2458-13-154CrossRefGoogle ScholarPubMed
Han, K-M, Ko, Y-H, Shin, C, Lee, J-H, Choi, J, Kwon, D-Y et al. Tinnitus, depression, and suicidal ideation in adults: a nationally representative general population sample. J Psychiatr Res 2018;98:124–32CrossRefGoogle ScholarPubMed
Seo, JH, Kang, JM, Hwang, SH, Han, KD, Joo, YH. Relationship between tinnitus and suicidal behaviour in Korean men and women: a cross-sectional study. Clin Otolaryngol 2016;41:222–710.1111/coa.12500CrossRefGoogle ScholarPubMed
Lee, D-H, Kim, YS, Chae, HS, Han, K. Nationwide analysis of the relationships between mental health, body mass index and tinnitus in premenopausal female adults in Korea: 2010–2012 KNHANES. Sci Rep 2018;8:7028CrossRefGoogle ScholarPubMed
Aazh, H, Moore, BCJ. Thoughts about suicide and self-harm in patients with tinnitus and hyperacusis. J Am Acad Audiol 2018;29:255–61Google ScholarPubMed
Fox-Thomas, LG. Suicidal ideation among patients with chronic tinnitus. Hear J 2016;69:10CrossRefGoogle Scholar
Aazh, H, Landgrebe, M, Danesh, AA. Parental mental illness in childhood as a risk factor for suicidal and self-harm ideations in adults seeking help for tinnitus and/or hyperacusis. Am J Audiol 2019;28:527–3310.1044/2019_AJA-18-0059CrossRefGoogle ScholarPubMed
Tyler, RS, Baker, LJ. Difficulties experienced by tinnitus sufferers. J Speech Hear Disord 1983;48:150–4CrossRefGoogle ScholarPubMed
Vogel, I, Van de Looij-Jansen, PM, Mieloo, CL, Burdorf, A, de Waart, F. Risky music listening, permanent tinnitus and depression, anxiety, thoughts about suicide and adverse general health. PloS One 2014;9:e98912CrossRefGoogle ScholarPubMed
Nock, MK, Borges, G, Bromet, EJ, Alonso, J, Angermeyer, M, Beautrais, A et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry J Ment Sci 2008;192:98–105CrossRefGoogle ScholarPubMed
Borges, G, Nock, MK, Haro Abad, JM, Hwang, I, Sampson, NA, Alonso, J et al. Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. J Clin Psychiatry 2010;71:1617–28CrossRefGoogle ScholarPubMed
Druss, B, Pincus, H. Suicidal ideation and suicide attempts in general medical illnesses. Arch Intern Med 2000;160:1522–6CrossRefGoogle ScholarPubMed
Harris, EC, Barraclough, BM. Suicide as an outcome for medical disorders. Medicine (Baltimore) 1994;73:281–96CrossRefGoogle ScholarPubMed
Simpson, G, Tate, R. Suicidality in people surviving a traumatic brain injury: prevalence, risk factors and implications for clinical management. Brain Inj 2007;21:1335–51CrossRefGoogle ScholarPubMed
Calati, R, Laglaoui Bakhiyi, C, Artero, S, Ilgen, M, Courtet, P. The impact of physical pain on suicidal thoughts and behaviors: meta-analyses. J Psychiatr Res 2015;71:16–32CrossRefGoogle ScholarPubMed
Stubbs, B. The prevalence and odds of suicidal thoughts, behaviours and deaths among people with painful comorbidities: an updated meta-analysis accounting for publication bias. J Psychiatr Res 2016;72:72–3CrossRefGoogle ScholarPubMed
Kolva, E, Hoffecker, L, Cox-Martin, E. Suicidal ideation in patients with cancer: a systematic review of prevalence, risk factors, intervention and assessment. Palliat Support Care 2020;18:206–19CrossRefGoogle ScholarPubMed
Shepard, MD, Perepezko, K, Broen, MPG, Hinkle, JT, Butala, A, Mills, KA et al. Suicide in Parkinson's disease. J Neurol Neurosurg Psychiatry 2019;90:822–9CrossRefGoogle ScholarPubMed
Elamoshy, R, Bird, Y, Thorpe, L, Moraros, J. Risk of depression and suicidality among diabetic patients: a systematic review and meta-analysis. J Clin Med 2018;7:44510.3390/jcm7110445CrossRefGoogle ScholarPubMed
Li, Z, Yang, Y, Dong, C, Li, L, Cui, Y, Zhao, Q et al. The prevalence of suicidal ideation and suicide attempt in patients with rheumatic diseases: a systematic review and meta-analysis. Psychol Health Med 2018;23:1025–3610.1080/13548506.2018.1476724CrossRefGoogle ScholarPubMed
Lehmann, M, Kohlmann, S, Gierk, B, Murray, AM, Löwe, B. Suicidal ideation in patients with coronary heart disease and hypertension: baseline results from the DEPSCREEN-INFO clinical trial. Clin Psychol Psychother 2018;25:754–64CrossRefGoogle ScholarPubMed
Drapeau, CW, Nadorff, MR. Suicidality in sleep disorders: prevalence, impact, and management strategies. Nat Sci Sleep 2017;9:213–26CrossRefGoogle ScholarPubMed
Weissman, MM, Bland, RC, Canino, GJ, Greenwald, S, Hwu, HG, Joyce, PR et al. Prevalence of suicide ideation and suicide attempts in nine countries. Psychol Med 1999;29:9–17CrossRefGoogle ScholarPubMed
Mergl, R, Koburger, N, Heinrichs, K, Székely, A, Tóth, MD, Coyne, J et al. What are reasons for the large gender differences in the lethality of suicidal acts? An epidemiological analysis in four European countries. PLoS ONE 2015;10:e012906210.1371/journal.pone.0129062CrossRefGoogle ScholarPubMed
Dennis, M, Baillon, S, Brugha, T, Lindesay, J, Stewart, R, Meltzer, H. The spectrum of suicidal ideation in Great Britain: comparisons across a 16–74 years age range. Psychol Med 2007;37:795–80510.1017/S0033291707000013CrossRefGoogle ScholarPubMed
Andersson, G, Westin, V. Understanding tinnitus distress: introducing the concepts of moderators and mediators. Int J Audiol 2008;47(suppl 2):106–11110.1080/14992020802301670CrossRefGoogle ScholarPubMed
Choi, Y-J, Lee, W-Y. The prevalence of suicidal ideation and depression among primary care patients and current management in South Korea. Int J Ment Health Syst 2017;11:18CrossRefGoogle ScholarPubMed
Wiborg, JF, Gieseler, D, Löwe, B. Suicidal ideation in German primary care. Gen Hosp Psychiatry 2013;35:366–9CrossRefGoogle ScholarPubMed
Goodwin, RD, Kroenke, K, Hoven, CW, Spitzer, RL. Major depression, physical illness, and suicidal ideation in primary care. Psychosom Med 2003;65:501–5CrossRefGoogle ScholarPubMed
Olfson, M, Weissman, MM, Leon, AC, Sheehan, DV, Farber, L. Suicidal ideation in primary care. J Gen Intern Med 1996;11:447–53CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Tinnitus: assessment and management. NICE Guideline [NG155]. In: https://www.nice.org.uk/guidance/ng155 [1 November 2020]Google Scholar
Baldo, P, Doree, C, Molin, P, McFerran, D, Cecco, S. Antidepressants for patients with tinnitus. Cochrane Database Syst Rev 2012;(9):CD003853CrossRefGoogle Scholar
Borges, G, Angst, J, Nock, MK, Ruscio, AM, Kessler, RC. Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. J Affect Disord 2008;105:25–3310.1016/j.jad.2007.01.036CrossRefGoogle ScholarPubMed
Mathias, CW, Furr, RM, Sheftall, AH, Hill-Kapturczak, N, Crum, P, Dougherty, DM. What's the harm in asking about suicidal ideation? Suicide Life Threat Behav 2012;42:341–51CrossRefGoogle ScholarPubMed
Walker, J, Hansen, CH, Hodges, L, Thekkumpurath, P, O'Connor, M, Sharma, N et al. Screening for suicidality in cancer patients using item 9 of the nine-item patient health questionnaire; does the item score predict who requires further assessment? Gen Hosp Psychiatry 2010;32:218–2010.1016/j.genhosppsych.2009.11.011CrossRefGoogle ScholarPubMed
Hall, DA, Haider, H, Szczepek, AJ, Lau, P, Rabau, S, Jones-Diette, J et al. Systematic review of outcome domains and instruments used in clinical trials of tinnitus treatments in adults. Trials 2016;17:27010.1186/s13063-016-1399-9CrossRefGoogle ScholarPubMed
Bolton, JM, Pagura, J, Enns, MW, Grant, B, Sareen, J. A population-based longitudinal study of risk factors for suicide attempts in major depressive disorder. J Psychiatr Res 2010;44:817–26CrossRefGoogle ScholarPubMed
Sokero, TP, Melartin, TK, Rytsälä, HJ, Leskelä, US, Lestelä-Mielonen, PS, Isometsä, ET. Suicidal ideation and attempts among psychiatric patients with major depressive disorder. J Clin Psychiatry 2003;64:1094–100CrossRefGoogle ScholarPubMed
May, AM, Klonsky, ED, Klein, DN. Predicting future suicide attempts among depressed suicide ideators: a 10-year longitudinal study. J Psychiatr Res 2012;46:946–52CrossRefGoogle ScholarPubMed