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The Hyperacusis Questionnaire, loudness discomfort levels, and the Hospital Anxiety and Depression Scale: A cross-sectional study
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.ORCID iD: 0000-0001-5921-2428
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Linköping University .
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
2013 (English)In: Hearing, Balance and Communication, ISSN 2169-5717, Vol. 11, no 2, 72-79 p.Article in journal (Refereed) Published
Abstract [en]

Objective: 

The aim of this study was to compare hyperacusis measurement tools often used in audiological practice in order to determine the most valid measure for assessing hyperacusis. Another aim was to examine the mean value for the Hyperacusis Questionnaire (HQ) in this patient group. 

Design: 

This was a cross-sectional study to compare the HQ with loudness discomfort levels (LDL), the Hospital Anxiety and Depression Scale (HADS), and items from a clinical interview dealing with hyperacusis symptoms. Sixty-two patients between the ages of 18 and 61 years were evaluated. All patients were diagnosed with hyperacusis. 

Results: 

There were significant negative correlations between the HQ and nearly all LDL scores for the right ear, but no significant correlations could be found for the left ear. LDLs were significantly correlated with the anxiety subscale of the HADS while there were no significant correlations between the HQ and either of the HADS scales. Of the 62 patients, 41 scored above and 21 scored below the previously recommended cut-off for the HQ. 

Conclusion: 

We suggest that clinicians should use the HQ and HADS in combination with a clinical interview to diagnose hyperacusis, and propose that the cut-off for the Swedish version of the HQ should be lowered.

Place, publisher, year, edition, pages
2013. Vol. 11, no 2, 72-79 p.
Keyword [en]
Hyperacusis, assessment
National Category
Medical and Health Sciences
Research subject
Psychiatry; Oto-Rhino-Laryngology
Identifiers
URN: urn:nbn:se:uu:diva-206736DOI: 10.3109/21695717.2013.780409OAI: oai:DiVA.org:uu-206736DiVA: diva2:645280
Available from: 2013-09-03 Created: 2013-09-03 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.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 934
Keyword
Hyperacusis, Cognitive Behaviour Therapy, Randomized Controlled Trial, Personality, Psychiatric Disorders
National Category
Psychiatry Otorhinolaryngology Applied Psychology
Research subject
Psychiatry
Identifiers
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)
Opponent
Supervisors
Funder
Swedish Research Council
Available from: 2013-10-08 Created: 2013-09-16 Last updated: 2014-01-23

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Publisher's full texthttp://informahealthcare.com/doi/abs/10.3109/21695717.2013.780409

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Jüris, LindaEkselius, LisaLarsen, Hans Christian

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