Diagnostic Criteria for Psychosomatic Research and psychosocial functioning in tinnitus

Background: Tinnitus is a phantom perception in absence of an external sound source that affects about 278 million people worldwide. This study aimed at investigating for the first time the prevalence of Diagnostic Criteria for Psychosomatic Research (DCPR) in patients with tinnitus and whether DCPR syndromes were able to predict the degree of impairment associated with tinnitus. Methods: A total of 60 consecutive outpatients (51.3 % female; mean age 53.8) with Tinnitus were recruited from the Otorhinolaryngology Unit - University of Bari General Hospital. We assessed psychological distress and handicap associated with tinnitus (THI), psychopathological symptoms (SCL-90-R), anxiety (STAI), depression (BDI), cognitive impairment (MMSE), frontal lobe functions (FAB). Psychosomatic syndromes were investigated with the Structured Interview for DCPR. Results: A total of 45 patients (75%) met criteria for at least one DCPR and 40 patients (70%) had more than one DCPR. Total number of DCPR diagnoses was 90 (mean = 1.5 per patient). Higher prevalence of DCPR syndromes were found for Illness denial (n=18, 30%), Demoralization (n=12, 20%), Type A behavior (n=10, 17%), Irritable mood (n=9, 15%). Patients meeting DCPR criteria scored higher on THI (57.8±23.6, p<.05) and BDI (13.1±8,p<.05). A hierarchical regression model was used with THI as dependent variable. THI was significantly predicted by cognitive impairment (12%), depression (13%) and DCPR Somatization (10%). Conclusions: DCPR classification can provide otorhinolaryngology professionals with a set of sensitive diagnostic criteria for a comprehensive assessment of the tinnitus patient.