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Psychiatric Comorbidity and Personality Traits in Patients with Hyperacusis.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery. (psykiatri)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. (psykiatri)
2013 (English)In: International Journal of Audiology, ISSN 1499-2027, Vol. 52, no 4, 230-235 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Hyperacusis, defined as unusual intolerance of ordinary environmental sounds, is a common problem. In spite of this, there is limited understanding of the underlying mechanisms. We hypothesized that individuals withhyperacusis would be prone to suffer from psychiatric disorders, related in particular to anxiety. Therefore, psychiatric morbidity and personality traits were investigated, along with different sociodemographic and clinical characteristics. Design: Patientswere assessed with a clinical interview related to symptoms of hyperacusis, the Mini-international neuropsychiatric interview (MINI), and the Swedish Universities scales ofPersonality (SSP) to study psychiatric disorders and personality traits. Study sample: A group of 62 Swedish patients with hyperacusis between 18 and 61 years (mean 40.2, SD 12.2) was included. Results: Altogether 56% of the patients had at least onepsychiatric disorder, and 47% had an anxiety disorder. Also, personality traits related to neuroticism were over-represented. A majority, 79%, suffered from comorbid tinnitus, and a similar proportion used measures to avoid noisy environments. Conclusions: The over-representation of anxiety disorders and anxiety-relatedpersonality traits in patients with hyperacusis suggests common or cooperating mechanisms. Cognitive behavioural treatment strategies, proven efficient in treating anxiety, may be indicated and are suggested for further studies.

Place, publisher, year, edition, pages
2013. Vol. 52, no 4, 230-235 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-190576DOI: 10.3109/14992027.2012.743043ISI: 000316810100003OAI: oai:DiVA.org:uu-190576DiVA: diva2:583766
Available from: 2013-01-08 Created: 2013-01-08 Last updated: 2014-01-23Bibliographically approved
In thesis
1. Hyperacusis: Clinical Studies and Effect of Cognitive Behaviour Therapy
Open this publication in new window or tab >>Hyperacusis: Clinical Studies and Effect of Cognitive Behaviour Therapy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hyperacusis is a type of decreased sound tolerance where the individual has decreased loudness discomfort levels (LDL), normal hearing thresholds and is sensitive to ordinary environmental sounds. Persons with hyperacusis frequently seek help at audiological departments as they are often affected by other audiological problems. Regrettably, there is neither a consensus-based diagnostic procedure nor an evidence-based treatment for hyperacusis.

The principal aim of this thesis was to gain knowledge about the clinical condition hyperacusis. The specific aim of Paper I was to compare hyperacusis measurement tools in order to determine the most valid measures for assessing hyperacusis. Items from a constructed clinical interview were compared with the LDL test, the Hyperacusis Questionnaire (HQ) and the Hospital Anxiety and Depression Scale (HADS). LDLs were significantly correlated with the anxiety subscale of the HADS. A third of the 62 investigated patients scored below the previously recommended cut-off for the HQ. The results suggest that HQ and HADS in combination with a clinical interview are useful as part of the assessment procedure in patients with hyperacusis.

The aim of Paper II was to further investigate the patient group with respect to individual characteristics, psychiatric morbidity and personality traits. It was shown that anxiety disorders and anxiety-related personality traits were over-represented, which suggests common or cooperating mechanisms. Avoidance behaviour proved to be very common in the patient group, as was being unable to work due to hyperacusis.

In Paper III it was investigated in a randomized controlled trial whether Cognitive Behaviour Therapy (CBT) could be helpful for patients with hyperacusis. The effect of CBT for hyperacusis was assessed with measures of LDLs, symptoms of hyperacusis and of anxiety and depression, fear of (re)injury due to exposure to sounds, and quality of life, compared to a waiting list control group. There were significant group effects for a majority of the measures with moderate and strong effect sizes within- and between groups. After assessment the waiting list group was also given CBT, and was then reassessed with similar effects. The results were maintained for 12 months, concluding CBT to be potentially helpful for these patients.


Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 64 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 934
Hyperacusis, Cognitive Behaviour Therapy, Randomized Controlled Trial, Personality, Psychiatric Disorders
National Category
Psychiatry Otorhinolaryngology Applied Psychology
Research subject
urn:nbn:se:uu:diva-207577 (URN)978-91-554-8756-0 (ISBN)
Public defence
2013-10-31, Universitetshuset, room IX, Biskopsgatan 3, Uppsala, 13:15 (Swedish)
Swedish Research Council
Available from: 2013-10-08 Created: 2013-09-16 Last updated: 2014-01-23

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