Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis

Background: There are conflicting reports with regard to the relationship between suicidal ideations and tinnitus and hyperacusis. Audiology departments play a major role in offering therapy and support for patients experiencing tinnitus and hyperacusis. If suicidal and self-harm ideations among patients seen in audiology clinics are high, then it would be important to screen for them to make onward referrals to mental health services. Purpose: The aim of this study was to assess the prevalence of and factors related to suicidal and self-harm ideations in patients with tinnitus and hyperacusis seen at an audiology outpatient service. Research Design: This study was a part of a service evaluation survey using a correlational design. Study Sample: All patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic of the National Health Service in the United Kingdom in a 1-yr period were asked to complete the survey questionnaires (n = 402). Data Collection and Analysis: The focus of this article is on analysis of the patients' responses about suicidal and self-harm ideations as measured via the Patient Health Questionnaire, item 9, and their associated factors. Results: A total of 150/402 of patients answered the question about suicidal and self-harm ideations. Of these, 13% indicated that they had suicidal or self-harm ideations in the past 2 weeks. Suicidal and self harm ideations were moderately correlated with scores on the anxiety and depression subscales of the hospital anxiety and depression scale. Suicidal and self-harm ideations decreased with increasing age. There were small statistically significant correlations between suicidal and self-harm ideations and tinnitus handicap, hyperacusis handicap, insomnia, and scores on the visual analog scale (VAS) of effect of tinnitus on life. The correlations between suicidal and self-harm ideations and gender, pure-tone average of the worse and better ears, uncomfortable loudness levels of the worse ears, and VAS of tinnitus loudness and annoyance were not statistically significant. A regression model showed that abnormal depression scores increased the chance of suicidal and self-harm ideations by a factor of 6.2 (95% confidence interval = 1.13-34.1, p = 0.036). Conclusions: Audiologists offering tinnitus and hyperacusis rehabilitation should screen for suicidal and self-harm ideations among patients, especially for those with comorbid depression, and make onward referral to appropriate services when needed.