People with a prior diagnosis of major depressive disorder (MDD) may be at an increased risk for tinnitus, according to a study published in the Journal of Affective Disorders. Few studies have examined the relationship between tinnitus and depressive disorders, although the conditions may share similar pathophysiology and may be frequently comorbid.

In this case-control study, researchers analyzed data from the National Health Insurance Database in Taiwan. Patients with tinnitus in the database were recruited as cases (n=18,365), whereas data of propensity score-matched patients without tinnitus were recruited as the controls (n=18,365). The researchers investigated the association between prior MDD and tinnitus with logistic regression models.

Among patients with tinnitus and tinnitus-free controls, MDD was reported in 2.16% and 1.24% of the sample, respectively. In the logistic regression model, a prior diagnosis of MDD within 3 years before the index date was significantly associated with tinnitus (adjusted odds ratio [aOR], 1.74; 95% CI, 1.47-2.05). This relationship remained significant in later sensitivity analyses.

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There were significant associations between a prior MDD diagnosis and tinnitus in patients with diabetes (aOR, 2.05; 95% CI, 1.46-2.86) and hyperlipidemia (aOR, 1.94; 95% CI, 1.50-2.52). Positive associations also existed between a prior MDD diagnosis and tinnitus in patients between the ages of 20 and 34 years (aOR, 3.09; 95% CI, 1.64-5.81), 35 and 44 years (aOR, 1.77; 95% CI, 1.20-2.60), 45 and 54 years (aOR, 1.51; 95% CI, 1.09-2.10), and 55 and 64 years (aOR, 2.16; 95% CI, 1.54-3.04).

The limitations of this database analysis included the lack of information on participants’ lifestyle and genetics, the inclusion of patients who were mostly Han Chinese, and the lack of patients <20 years of age.

The investigators suggested that “clinicians should be alert about the tinnitus condition among patients with MDD.” They also noted, “If a patient reports tinnitus symptoms, the attending physician should also examine the emotional state of the patient and provide appropriate interventions.”


Kao LT, Shih JH, Yeh CB, et al. Association between major depressive disorder and subsequent tinnitus: A population-based study. J Affect Disord. 2020;263:367-372.