Impact of chronic otitis media on mental health


  • Imelda Rani Thomas Department of ENT, Yenepoya Medical College, Mangalore, Karnataka, India
  • Sharwak Ramlan Department of ENT, Yenepoya Medical College, Mangalore, Karnataka, India



Chronic suppurative otitis media, Depression, Anxiety, Stress, Quality of life, Chronic ear survey, Pure tone audiometry


Background: Chronic otitis media can lead to a decline in health-related quality of life as well as social behaviour, putting persons at risk for depression, anxiety, and interpersonal antagonism. The goal of this study is to look at the relationship between depression, anxiety, and stress and also to assess the quality of life in CSOM patients. Objectives of the current investigation was to study the correlation of depression, anxiety and stress in patients suffering from CSOM and to know the quality of life in patients suffering from CSOM.

Methods: This is a cross-sectional study conducted at tertiary care hospital of Karnataka. Ninety-four patients of chronic suppurative otitis media were included in the study. The measurement of hearing loss was carried out by pure tone audiometry and the depression, anxiety and stress were scored taking depression, anxiety and stress scale and quality of life was assessed with chronic ear survey questionnaire.

Results: Patients with bilateral ear affected was found to have statistically significant depression and anxiety. Positive correlations found between DASS and CES score with hearing loss.

Conclusions: Depression, anxiety and stress in patients with CSOM caused by symptoms and saactivity restriction should be assessed during and after treatments and risk factors should be identified so that counselling and appropriate medications can be utilized to treat it if required. It will guide health care providers and researchers in effectively managing the impacts of CSOM.

Author Biography

Imelda Rani Thomas, Department of ENT, Yenepoya Medical College, Mangalore, Karnataka, India

Department of Otorhinolaryngology


Idstad M, Tambs K, Aarhus L, Engdahl BL. Childhood sensorineural hearing loss and adult mental health up to 43 years later: results from the HUNT study. BMC Public Health. 2019;19(1):168.

Lovibond, SH, Lovibond, PF. Manual for the Depression Anxiety Stress Scales. Available at: Accessed on 20 October 2021.

Depression anxiety stress scale. Available at: Accessed on 20 October 2021.

Nadol BJ, Staecker H, Gliklich R. Outcomes assessment for chronic otitis media: the chronic ear survey. Laryngoscope. 2000;110(3):32-5.

Li C, Zhang X, Hoffman HJ. Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005-2010. JAMA Otolaryngol Head Neck Surg. 2014;140:293-302.

Mehboob S, Rafi ST, Ahmed N, Mehjabeen. Association of hearing loss with depression, anxiety and stress in patients suffering from Chronic Suppurative Otitis Media. Pak J Med Sci. 2019;35(2):510-4.

Gomaa MAM, Elmagd MHA, Elbadry MM, Kader RM (2014) Depression, anxiety and stress scale in patients with tinnitus and hearing loss. Eur Arch Otorhinolaryngol. 2014;271:2177-84.

Hasson D, Theorell T, Wallen M, Leineweber C, Canlon B. Stress and prevalence of hearing problem in Swedish working population. BMC Public Health. 2011;11:130

Hsu WT, Hsu CC, Wen MH, Lin HC, Tsai HT, Su P, et al. Increased risk of depression in patients with acquired sensory hearing loss: A 12 year follow-up study. Med. 2016;95:5312.

Bernabei V, Morini V, Moretti F, Marchiori A, Ferrari B, Dalmonte E, et al. Vision and hearing impairments are associated with depressive--anxiety syndrome in Italian elderly. Aging Ment Health. 2011;15:467-74.

Graaf R, Bijl RV. Determinants of mental distress in adults with a severe auditory impairment: differences between prelingual and postlingual deafness. Psychosom Med. 2002;64(1):61-70.

Fellinger J, Holzinger D, Dobner U, Gerich J, Lehner R, Lenz G, et al. Mental distress and quality of life in a deaf population. Soc Psychiatry Psychiatr Epidemiol. 2005;40(9):737-42.

Leposavic´ L, Leposavic´ I, Jasovic´-Gasic´ M, Milovanovic´ S, Nikolic´-Balkoski G. Psychosocial aspects of acquired hearing impairment in the patients with otosclerosis. Psychiatr Danub. 2006;18:30-8.

Newman CW, Weinstein BE, Jacobson GP, Hug GA. The Hearing Handicap Inventory for adults: psychometric adequacy and audiometric correlates. Ear Hear. 1990;11(6):430-3.

Eriksson-Mangold M, Carlsson SG. Psychological and somatic distress in relation to perceived hearing disability, hearing handicap, and hearing measurements. J Psychosom Res. 1991;35(6):729-40.

Monzani D, Galeazzi GM, Genovese E, Marrara A, Martini A. Psychological profile and social behaviour of working adults with mild or moderate hearing loss. Acta Otorhinolaryngol Ital. 2008;28(2):61-6.

Baumann I, Gerendas B, Plinkert PK, Praetorius M. General and disease-specific quality of life in patients with chronic suppurative otitis media: a prospective study. Health Qual Life Outcomes. 2011;9(1):48.

Meijer AG, Wit HP, TenVergert EM, Albers FW, Muller Kobold JE. Reliability and validity of the (modified) Amsterdam Inventory for auditory disability and handicap. Int J Audiol. 2003;42(4):220-6.

Bakir S, Kinis V, Bez Y, Gun R, Yorgancilar E, Ozbay M, Aguloglu B, Meric F. Mental health and quality of life in patients with chronic otitis media. Eur Arch Otorhinolaryngol. 2013;270(2):521-6.






Original Research Articles