[Tinnitus in primarily schizophrenic patients].
BACKGROUND
Tinnitus, a ringing in the ear perceived only by the person concerned, occurs not only in the general population but also among patients suffering from schizophrenia. They may be afflicted by tinnitus and acoustic hallucinations at the same time. Misinterpreting their schizophrenic illness, patients prefer to consult a family doctor or an ear, nose and throat (ENT) specialist rather than a psychiatrist if they mistake their acoustic hallucinations for tinnitus. Conversely, in schizophrenia patients, tinnitus of recent onset can be mistaken for acoustic hallucination and may be treated with neuroleptics rather than by a symptom-oriented management approach. This paper aims to present treatment approaches and criteria for distinguishing between acoustic hallucinations, which occur often in schizophrenia, and tinnitus, and to highlight treatment options.


METHODS
From October 1999 to October 2004, we investigated 31 schizophrenic inpatients (17 men [55%], 14 women [45%] aged between 29 and 60 years, mean: 44 years) suffering from tinnitus. A total of 11 patients were treated mainly for tinnitus in a specialized neurootological clinic, 11 were treated in a psychiatric clinic, and 9 patients were treated in a psychiatric day center. All patients were examined using psychiatric and neurootological standards.


RESULTS
Differences were found between tinnitus and acoustic hallucinations in the patients' descriptions and the audiometric outcomes. Tinnitus was mainly found in higher frequencies ranging from 4000 to 8000 Hz. Tinnitus was masked at an average of 9.3 dB and a maximum of 15 dB above the auditory threshold. Six patients (19%) had normal hearing, while ten patients (32%) had unilateral hearing loss and 15 patients had bilateral hearing loss. Hearing aids were indicated in 14 patients, but only five patients accepted them.


CONCLUSIONS
Schizophrenic patients suffering from tinnitus benefit from basic standards of tinnitus treatment. However, psychiatric specialists should also provide the drug treatment that is often necessary as well as psychoeducation for schizophrenia.
Zentrum für Soziale Psychiatrie Rheinblick, Klinik für Psychiatrie und Psychotherapie Eichberg, Kloster-Eberbach-Strasse 4, 65346 Eltville. info@zsp-rheinblick.de
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Dölberg
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Schaaf
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Hesse
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000150:complications* / Q000628:therapy*; D012565:Schizophrenic Psychology; D014012:Tinnitus / Q000150:complications / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome