Objective: The study aimed to characterize the multidimensional burden of tinnitus on health-related quality of life (HRQoL) using the EQ-5D-5L dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) moving beyond symptom severity alone.

Methods: A cross-sectional analysis was conducted using baseline data (n = 428, mean age = 54.9 years, 51.9% female) from several clinical trials examining the efficacy of internet-based cognitive behavioral therapy for tinnitus. Data was collected using a series of online questionnaires including demographic, audiological, and clinical variables. HRQoL was assessed using the EQ-5D-5L profile dimensions.

Results: Participants primarily reported no problems with mobility (76.6%), self-care (92.5%), and usual activities (65.2%); however, pain/discomfort (33.4%) and anxiety/depression (40.2%) were the most affected EQ-5D-5L dimensions at baseline. Higher tinnitus severity was consistently associated with worse outcomes across all dimensions (p < 0.05). A 10-point increase in Tinnitus Functional Index (TFI) scores was associated with 53% and 51% higher odds of worse usual activities and anxiety/depression, respectively. Participants reporting a fully healthy EQ-5D-5L profile had substantially lower tinnitus severity compared to those with any reported problems (mean TFI: 39.0 vs 55.3; d=0.78). Cluster analyses identified a smaller subgroup with markedly poorer multidimensional health, characterized by higher tinnitus severity and greater psychological and sleep-related distress, with no significant differences in demographic or audiological characteristics between profile.

Conclusion: Tinnitus severity is associated with multidimensional reductions in health-related quality of life, particularly in functional activity and emotional health. The identification of a high-burden profile characterized by anxiety, depression, sleep disturbance, and activity limitation highlights the need for integrated, biopsychosocial approaches to tinnitus management.