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The purpose of this paper is to determine a tinnitus patient information pack’s (TPIP) usefulness in patients suffering with tinnitus with respect to their need for further tinnitus retraining therapy (TRT) and in reducing TRT cancellations and non-attenders.

The paper consists of prospective case series in a district general hospital ENT out-patient department.

Patients with tinnitus-related symptoms constitute around 2 per cent of the ENT OPD workload at the West Middlesex Hospital, Chelsea & Westminster NHS Trust, London, i.e., 365 patients with intrusive tinnitus were referred by the ENT surgeon for TRT; 56/365 patients (15.3 per cent) failed to attend and 60 (16.4 per cent) cancelled their appointments. The following year, a TPIP was administered to all tinnitus sufferers, despite the affliction’s intrusiveness, and told to contact the audiology department if they felt that TRT was required, which resulted in 43/233 patients (18.5 per cent) over a one-year period self-referring for TRT; 2/233 (0.9 per cent) did not attend, and 1/233 (0.4 per cent) were cancelled appointments.

The patient-focussed TPIP acts as an initial therapy for the tinnitus sufferer by providing reassurance and self-therapy. This results in patients who are less likely to seek TRT, leading to more efficient clinical resource usage (p<0.01).

The data suggest that all tinnitus sufferers presenting to ENT clinics could be handed a TPIP and empowered with the decision whether they require further intervention.

The purpose of this paper is to investigate the mediating role of psychological problems (stress, anxiety, depression) between hearing impairment (HI) and tinnitus in tinnitus patients. Sample comprised of 110 patients (male, n=70; female, n=40).

The purposive sampling technique was used based on correlational design. Two scales, tinnitus handicap inventory developed by Newman et al. (1996), and depression, anxiety and stress scale developed by Lovibond and Lovibond (1995), were employed to assess tinnitus, anxiety, stress and depression among tinnitus patients.

The study revealed that tinnitus was positively significant correlated with depression (r=0.55, p<0.001), anxiety (r=0.63, p<0.001), stress (r=0.54, p<0.001) and hearing loss (r=0.81, p<0.001). The results also revealed that hearing loss was positively significant predictor for tinnitus (β=20.72, p<0.001). Further, it was revealed that tinnitus was positively significant predicted by anxiety (β=2.62, p<0.001), stress (β=2.33, p<0.001) and depression (β=2.71, p<0.001); the interaction between psychological symptoms and hearing loss was negatively significant predictor for stress (β=−0.51, p<0.001), anxiety (β=−0.57, p<0.001) and depression (β=−0.62, p<0.001). Moreover, it was revealed that female tinnitus patients were more predisposed to stress, anxiety and depression as compared to male tinnitus patients. Results also elaborated that those tinnitus patient who had profound HI were less inclined toward psychological problems as compared to those tinnitus patients who had mild to moderate level of HI. This study would be helpful for the clinical setting to tackle the psychological problems of tinnitus patients.

This study consisted on population from urban cities of Pakistan; therefore, the findings cannot be generalized on overall population. In future, descriptive as well as experimental studies will be beneficial to describe the mechanism of tinnitus across gender in detail. Native tool for measuring gender-related problems would be effective in future as it integrates cultural aspects as well.

There is a consensus across researchers that tinnitus is one of the most important biological problem which initiates various other psychological problem (Minen et al., 2014; Vogel et al., 2014). Numerous studies have been conducted to find out the relationship of tinnitus with various psychological and biological factors (Boi et al., 2012; Li et al., 2014; Marciano et al., 2003; McCormack et al., 2015; Møller et al., 2010; Udupi et al., 2013; Zöger et al., 2006).