Exploring tinnitus heterogeneity.

Tinnitus experiences differ widely. A greater understanding of the core processes underlying these variations is needed. Moreover, meaningful definitions for different subgroups are required to better manage this heterogeneous population. The objective of the present research was to contribute toward the understanding of tinnitus heterogeneity by identifying factors that can predict tinnitus severity and to ascertain if distinct subgroups of tinnitus presentation can be identified. This cross-sectional study consisted of 326 adults subdivided into subgroups of those with mild tinnitus (n=32; 10%), significant tinnitus (n=99; 30%) and severe tinnitus (n=195; 60%) according to their scores from the Tinnitus Functional Index. Multiple regression was used to identify factors associated with tinnitus severity. These factors included personal traits, tinnitus-related traits, treatment modalities and clinical comorbidities. Insomnia, hearing distress, and anxiety were the best predictors of tinnitus severity (explaining 53% of the variability). These comorbidities were stronger predictors than any demographical factors (that explained 11% of the variability). Distinct subgroups based on tinnitus severity (mild, significant, and severe) and anxiety levels were evident. Those with severe tinnitus had significantly more severe comorbidities compared with the mild and significant groups. This study highlights that people with tinnitus could initially be grouped according to tinnitus severity to direct further management. Those with higher tinnitus severity should receive more immediate and intensive care. Due to the strong associations between tinnitus severity and tinnitus-related comorbidities (e.g., insomnia, hearing disability, and anxiety), tinnitus assessment and interventions should focus on these comorbidities.

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