title: The Tinnitus Handicap Inventory as a screening test for psychiatric comorbidity in patients with tinnitus.
abstract: BACKGROUND
  Psychiatric comorbidity is common in patients who seek help for tinnitus. The perceived severity of tinnitus correlates closer to psychological and general health factors than to audiometrical parameters. Audiologists need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting. The tinnitus handicap inventory (THI) has gained widespread acceptance as a self-report measure of tinnitus handicap. In several studies, THI test score correlates with the level of psychopathologic distress. The aim of our study was to investigate the predictive power of the test THI in relation to psychiatric disorders.
  
  
  METHODS
  We recruited 156 patients with chronic tinnitus who have requested help at our tinnitus center. All patients underwent psychiatric evaluation, the diagnosis was made in agreement with the DSMIV-TR criteria; all patients filled out the following questionnaires: THI, Symptomatic Check List-90-Revised (SCL-90-R) and Stress-related Vulnerability Scale (VRS). Sensibility and specificity of tests as screening tool for psychiatric disorders was evaluated using Receiver Operating Characteristic (ROC) curve.
  
  
  RESULTS
  Sixty-eight patients (prevalence: 43.59%) were found to be affected by a psychiatric disorder. AUC = 0.792 (p > 0.001) shows that THI is a moderately accurate test to individuate psychiatric affected people among our sample. We identified a score of 36 at THI (sensibility = 86.76%; specificity = 59.09%) as an appropriate cut-off point.
  
  
  CONCLUSIONS
  If a patient reports a THI score greater than 36, the audiologist should supplement diagnostic studies with a psychiatric evaluation.
authors.affiliation: Department of Neurology and Psychiatry, Umberto I University Hospital, Sapienza University, Rome, Italy. massimo_salviati@yahoo.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Salviati
authors.forename: Francesco
authors.initials: F
authors.lastname: Macrì
authors.forename: Samira
authors.initials: S
authors.lastname: Terlizzi
authors.forename: Claudia
authors.initials: C
authors.lastname: Melcore
authors.forename: Alessandra
authors.initials: A
authors.lastname: Provenzano
authors.forename: Emilia
authors.initials: E
authors.lastname: Capparelli
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Altissimi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Cianfrone
mesh_terms: D000223:Adaptation, Psychological; D058443:Catastrophization / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011788:Quality of Life; D014012:Tinnitus / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology