title: Impact of Multiple Factors on the Degree of Tinnitus Distress.
abstract: OBJECTIVE
  The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors.
  
  
  METHODS
  We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history.
  
  
  RESULTS
  The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model.
  
  
  CONCLUSIONS
  Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.
authors.affiliation: Tinnitus Center, Universitätsmedizin Berlin Berlin, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Brüggemann
authors.affiliation: Department of Otorhinolaryngology, Universitätsmedizin Berlin Berlin, Germany.
authors.forename: Agnieszka J
authors.initials: AJ
authors.lastname: Szczepek
authors.affiliation: Department of Internal Medicine and Psychosomatics, Universitätsmedizin Berlin Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Rose
authors.affiliation: Royal National Throat Nose and Ear Hospital, University College Hospitals London, UK.
authors.forename: Laurence
authors.initials: L
authors.lastname: McKenna
authors.affiliation: Department of Otorhinolaryngology, Universitätsmedizin Berlin Berlin, Germany.
authors.forename: Heidi
authors.initials: H
authors.lastname: Olze
authors.affiliation: Tinnitus Center, Universitätsmedizin Berlin Berlin, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Mazurek
keywords: multi-level analyses; physical or psychological discomfort; social parameters; the grade of tinnitus-related distress; the psychological distress