Sudden Hearing Loss May Prompt Affective Disorders
By David Douglas
NEW YORK—Patients with idiopathic sudden sensorineural hearing loss are at increased risk of affective disorders, South Korean researchers have found.
"Practitioners need to keep this in mind and treat the whole person, and not just the hearing loss in one ear," editorialist Dr. Alan G. Micco of Feinberg School of Medicine, in Chicago, told Reuters Health by email. These patients "have a significantly increased incidence of developing depression or anxiety."
In their report, online May 31 in JAMA Otolaryngology-Head & Neck Surgery, Dr. Dong-Kyu Kim of Hallym University College of Medicine, in Chuncheon, and colleagues note, "Sudden sensorineural hearing loss (SSNHL) is one of the few otologic emergencies, and although it has a high spontaneous recovery rate, some affected patients experience partial or no recovery. For these patients, loss of function in an organ essential for communication is a terrifying experience and a significant stressor."
To help define the psychological impact, the team examined Korean National data from 2002 to 2013. They identified and followed 1,425 patients who had experienced such hearing loss and 7,125 propensity-matched controls who had not.
Over 11 years of follow-up, 225 (15.8%) of the patients with hearing loss developed affective disorders compared to 736 (10.3%) in the comparison group. Moreover the incidence of affective disorders was 14.3 per 1,000 person-years in the hearing loss group and 9.1 per 1,000 person-years in the comparison group.
After adjustment for other factors, the hearing loss group developed affective disorders significantly more frequently than those in the comparison group (hazard ratio, 1.50). This was true of developing depression (HR, 1.66) and of anxiety disorder (HR, 1.79), but not bipolar disorder.
Thus the researchers conclude that clinicians should consider patients with such hearing loss "to be at an increased risk of developing affective disorders, and take specific precautions to reduce their risk of depression and anxiety."
In his editorial, Dr. Micco suggests, "The clinician should refer these patients for proper assessment and treatment if necessary. Pursuing a team approach, including behavioral psychologists or psychiatrists, to help diagnose and manage these patient's affective disorder symptoms may be helpful"
Dr. Kim did not respond to requests for comments.
JAMA Otolaryngol Head Neck Surg 2018.
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