Daeyoung Roh1, Janet Ren Chao2, Do Hoon Kim3, Kyung Hee Yoon1, Jae Hoon Jung1, Chang Hyun Lee1, Ji-Hyeon Shin4, Min Jae Kim5, Chan Hum Park5, Jun Ho Lee6. 1. Department of Psychiatry, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea. 2. George Washington University, Washington D.C. 20037, USA. 3. Department of Psychiatry, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea. Electronic address: dohkim@hallym.or.kr. 4. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Republic of Korea. 5. Department of Otorhinolaryngology and Head and Neck Surgery, Hallym University Medical Center, Chuncheon, Republic of Korea. 6. Department of Otorhinolaryngology and Head and Neck Surgery, Hallym University Medical Center, Chuncheon, Republic of Korea. Electronic address: zoonox@nate.com.
Abstract
OBJECTIVE: Early prediction of therapeutic outcomes could reduce exposure to ineffective treatments and optimize clinical outcomes. However, none of the known otologic predictors is amenable to therapeutic intervention for idiopathic sudden sensorineural hearing loss (ISSNHL). The aims of this study were to investigate psychological stress as a potential predictor to discriminate outcomes in ISSNHL. METHODS: Various psychological measures were conducted including structured interview assessment tools in patients with recently diagnosed ISSNHL before initiating treatment. Using logistic regression analysis, we identified the predictors of treatment response and estimated the probability of treatment response in 50 ISSNHL patients who participated in a clinical trial. RESULTS: Treatment non-responders were significantly differentiated from responders by various psychological problems. The depression subscore of Modified form of Stress Response Inventory (SRI-MF) (p=0.007) and duration of hearing loss (p=0.045) significantly predicted treatment response after controlling other clinical correlates. The same predictors were identified from different treatment response measured using Siegel's criteria. The most discriminative measure for treatment response was SRI-MF depression score with an overall classification accuracy of 73%. CONCLUSIONS: We found depressive stress response to be the strong predictor of treatment response in patients with ISSNHL. Our results highlight the potential use of the psychiatric approach as a tool for enhancing therapeutic outcomes. Future stress intervention studies with larger number of ISSNHL patients are needed.
OBJECTIVE: Early prediction of therapeutic outcomes could reduce exposure to ineffective treatments and optimize clinical outcomes. However, none of the known otologic predictors is amenable to therapeutic intervention for idiopathic sudden sensorineural hearing loss (ISSNHL). The aims of this study were to investigate psychological stress as a potential predictor to discriminate outcomes in ISSNHL. METHODS: Various psychological measures were conducted including structured interview assessment tools in patients with recently diagnosed ISSNHL before initiating treatment. Using logistic regression analysis, we identified the predictors of treatment response and estimated the probability of treatment response in 50 ISSNHL patients who participated in a clinical trial. RESULTS: Treatment non-responders were significantly differentiated from responders by various psychological problems. The depression subscore of Modified form of Stress Response Inventory (SRI-MF) (p=0.007) and duration of hearing loss (p=0.045) significantly predicted treatment response after controlling other clinical correlates. The same predictors were identified from different treatment response measured using Siegel's criteria. The most discriminative measure for treatment response was SRI-MF depression score with an overall classification accuracy of 73%. CONCLUSIONS: We found depressive stress response to be the strong predictor of treatment response in patients with ISSNHL. Our results highlight the potential use of the psychiatric approach as a tool for enhancing therapeutic outcomes. Future stress intervention studies with larger number of ISSNHL patients are needed.