Introduction: Variable outcomes following the provision of tinnitus interventions are commonly reported, which may be related to the heterogeneity of tinnitus. Subgrouping (i.e. phenotyping) those with tinnitus, so that tailored interventions can be implemented, may reduce outcome variability. There is, however, no universally accepted way of classifying individuals with tinnitus. . The purpose of this study was (1) to test if the presence of tinnitus subgroups can be discerned based on hearing-related comorbidities and (2) to identify predictors of tinnitus severity for each subgroup identified.
Methods: This exploratory cross-sectional study included data from 2,980 adults with tinnitus. The study was nested within an online survey distributed worldwide to investigate tinnitus experiences during the COVID-19 pandemic. Cluster analysis was used to identify if unique subgroups based on hearing-related comorbidities were present. Multiple regression identified individual characteristics associated with greater tinnitus severity in each subgroup.
Results: A three-cluster solution identified three distinct subgroups, namely tinnitus-only individuals (44%), those presenting with tinnitus and hyperacusis (27%), and those with tinnitus and hearing loss (29%). Younger age and the presence of mental health problems predicted significantly greater tinnitus severity for all groups. In addition, a shorter duration since the onset of tinnitus and previously seeking treatment for tinnitus predicted more severe tinnitus for the group with tinnitus and hearing loss. Being a hearing aid wearer, additional physical health problems, help-seeking and hearing aids use predicted higher tinnitus severity for the tinnitus-only group.
Conclusions: The current findings have implication for tinnitus management, such as initially triaging tinnitus patients prior to their clinical appointments. Unique management pathways could be considered for each tinnitus subgroup. Those presenting with characteristics that put them at risk for greater tinnitus severity may be directed to more immediate and intensive interventions.