The effect of psychological inflexibility on health-related quality of life, depression, and anxiety in patients with chronic tinnitus without hearing loss

OBJECTIVE: The purpose of this study was to investigate the relationship between psychological inflexibility, depression, anxiety, and quality of life in patients with chronic tinnitus without hearing loss. METHODS: The study was carried out involving 85 patients with chronic tinnitus without hearing loss and a control group of 80 individuals. All participants completed the Acceptance and Action Questionnaire-II, the State-Trait Anxiety Inventory-Trait, the Beck Depression Inventory, and Short Form-36. RESULTS: The patient group exhibited higher Acceptance and Action Questionnaire-II (t=5.418, p<0.001), State-Trait Anxiety Inventory-Trait (t=6.592, p<0.001), and Beck Depression Inventory (t=4.193, p<0.001) scores and lower physical component summary (t=4.648, p<0.001) and mental component summary (t=-5.492, p<0.001) scores than the control group. Psychological inflexibility predicted depression, anxiety, and impairment of quality of life. The effect of psychological inflexibility on physical component summary was mediated by depression (β=−0.15, [95%CI −0.299 to −0.017]), while its effect on mental component summary was mediated by anxiety and serial anxiety and depression (β=−0.17 [95%CI −0.344 to −0.055] and β=−0.06 [95%CI −0.116 to −0.100], respectively). CONCLUSION: Psychological inflexibility plays an important role in patients with chronic tinnitus without hearing loss. It is associated with increased levels of anxiety and depression and decreased quality of life.