Gender-Specific Differences in Patients With Chronic Tinnitus—Baseline Characteristics and Treatment Effects

Abstract

Whilst some studies have identified gender-specific differences, there is no consensus about gender-specific determinants for prevalence rates or concomitant symptoms of chronic tinnitus such as depression or anxiety. However, gender-associated differences in psychological response profiles and coping strategies may differentially affect tinnitus chronification and treatment success rates. Thus, understanding gender-associated differences may facilitate a more detailed identification of symptom profiles, heighten treatment response rates, and help to create access for vulnerable populations that are potentially less visible in clinical settings. Our research questions are: RQ1: how do male and female tinnitus patients differ regarding tinnitus-related distress, depression severity, and treatment response, RQ2: to what extent are answers to questionnaires administered at baseline associated with gender, and RQ3: which baseline questionnaire items are associated with tinnitus distress, depression, and treatment response, while relating to one gender only? In this work, we present a data analysis workflow to investigate gender-specific differences in N = 1,628 patients with chronic tinnitus (828 female, 800 male) who completed a 7-day multimodal treatment encompassing cognitive behavioral therapy (CBT), physiotherapy, auditory attention training, and information counseling components. For this purpose, we extracted 181 variables from 7 self-report questionnaires on socio-demographics, tinnitus-related distress, tinnitus frequency, loudness, localization, and quality as well as physical and mental health status. Our workflow comprises (i) training machine learning models, (ii) a comprehensive evaluation including hyperparameter optimization, and (iii) post-learning steps to identify predictive variables. We found that female patients reported higher levels of tinnitus-related distress, depression and response to treatment (RQ1). Female patients indicated higher levels of tension, stress, and psychological coping strategies rates. By contrast, male patients reported higher levels of bodily pain associated with chronic tinnitus whilst judging their overall health as better (RQ2). Variables measuring depression, sleep problems, tinnitus frequency, and loudness were associated with tinnitus-related distress in both genders and indicators of mental health and subjective stress were Niemann et al.Gender-Specific Differences in Patients With Chronic Tinnitus found to be associated with depression in both genders (RQ3). Our results suggest that gender-associated differences in symptomatology and treatment response profiles suggest clinical and conceptual needs for differential diagnostics, case conceptualization and treatment pathways.

Predicting the gender of individuals with tinnitus based on daily life data of the TrackYourTinnitus mHealth platform

“…As our result show that the answers of the daily questionnaires can predict the gender of TYT users, inversely, the daily answers can be indicators for the symptom differences of men and women. As we further found out that the worst symptom is an important feature, we are in line with other research works beyond the scope of mHealth data 13 , 58 – 60 . Furthermore, studies that have found gender-related differences in tinnitus patients without using mHealth solutions might particularly benefit from the use of mHealth.…”

“…A recent special issue shows the latter kind of interest in research 12 . In the already published articles of this special issue, for example, one work deals with gender differences of chronic tinnitus patients 13 . All of the presented works show that gender differences are a valuable research direction in particular and with respect to research on subgroups of tinnitus patients in general.…”

Health-Related Quality of Life, Depressive Symptoms, Anxiety, and Somatization Symptoms in Male and Female Patients with Chronic Tinnitus

“…Overall, available evidence suggests that women tend to report higher HRQoL impairments in the context of psychological [38][39][40] or medical difficulties [41,42]. For chronic tinnitus, similar patterns emerged with women describing higher levels of emotional tension, psychological distress, and functional impairment [43][44][45][46], although these findings remain inconclusive [47,48]. To date, investigations on genderspecific differences in HRQoL for patients with chronic tinnitus are sparse.…”

A State-of-Art Review of Digital Technologies for the Next Generation of Tinnitus Therapeutics

“…Therefore, determinants of tinnitus-related distress provide valuable information about tinnitus categorization and desired therapy planning. Niemann et al ( 175 ) also identified that gender-associated differences may facilitate a more detailed identification of symptom profiles. AI may heighten treatment response rates, and help to create access for vulnerable tinnitus populations that are potentially less visible in clinical settings ( 35 ).…”