485. PSYCHIATRIC COMORBIDITY IN PATIENTS WITH TINNITUS OR AUDITORY HALLUCINATION AND SLEEP EVALUATION, SOUND THERAPY AND SHARED DECISION MAKING (SDM)

Abstract Background We reported psychiatric comorbidity (1375/1900, 72.4%) in patients with dizziness. Aims & Objectives In this study, we investigated about tinnitus or auditory hallucination. Method The subjects were 413 patients (167men, 246 women) with tinnitus and 39 patients (13 men, 26 women) with auditory hallucination. Psychiatric comorbidity was revealed in 77.5% (320/413) with tinnitus and in 97.4% (38/39) with auditory hallucination. AhHI (Auditory hallucination Handicup Inventory), which is a revised version of THI, was used as an evaluation method for auditory hallucinations. We reported psychiatric comorbidity (1375/1900, 72.4%) in patients with dizziness. In this study, we investigated about tinnitus or auditory hallucination. Results An evaluation of sleep disorders was effective using Insomnia Severity Index (ISI). Sound therapy was performed on 52 cases of tinnitus and 6 cases of auditory hallucinations. With sound therapy, Case 1 improved from THI 100 to 2 points and AhHI 98 to 0 points, and Case 2 improved from THI 32 to 0 points and AhHI 66 to 0 points. A 36-year-old woman (Case 3) with schizophrenia, whose main complaints were dizziness, tinnitus, and auditory hallucinations, had a THI of 86 points, AhHI of 76 points, DHI of 96 points, and ISI of 24 points. With psychiatric treatment her score improved to THI 42 points, AhHI 20 points, DHI 58 points, and ISI 11 points. The 77-year-old man (Case 4) with right paraocular auditory hallucinations did not have psychiatric comorbidity. An evaluation of sleep disorders was effective using Insomnia Severity Index (ISI). Sound therapy was performed on 52 cases of tinnitus and 6 cases of auditory hallucinations. As a treatment for auditory hallucination, sound therapy, oral antipsychotic drug and long-acting injection (LAI) were effective. Shared Decision Making (SDM) was performed to increase treatment continuation rates. Discussion & Conclusions We believe that neuro-otological evaluation and sleep evaluation are useful for treating tinnitus or auditory hallucinations, and that improving insomnia, reducing anxiety, sound therapy and SDM are also useful.