{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:08:33Z","timestamp":1787004513617,"version":"build-2736575974"},"reference-count":50,"publisher":"American Speech Language Hearing Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Audiol"],"published-print":{"date-parts":[[2017,12,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Those involved in the management of patients with tinnitus and\/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and\/or insomnia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1044\/2017_aja-17-0008","type":"journal-article","created":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T18:31:05Z","timestamp":1512498665000},"page":"562-569","source":"Crossref","is-referenced-by-count":45,"title":["Factors Associated With Depression in Patients With Tinnitus and Hyperacusis"],"prefix":"10.1044","volume":"26","author":[{"given":"Hashir","family":"Aazh","sequence":"first","affiliation":[{"name":"Tinnitus &amp; Hyperacusis Therapy Specialist Clinic, Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C. 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