Idiopathic tinnitus as part of hypochondriacal disorders

OBJECTIVE: To identify clinical features of psychopathological and pathocharacterological disorders in patients with idiopathic tinnitus and determine the typological and nosological pertinence of this psychopathological entity. MATERIAL AND METHODS: Forty-one patients (32 males and 9 females) aged 18 to 65 years diagnosed with tinnitus (H93.1 according to ICD-10) without organic causes were examined. Psychopathological, psychometric, clinical, and statistical methods were used; otolaryngological, neurological, and instrumental examinations were carried out. RESULTS: Idiopathic tinnitus can have variable manifestations: it can be permanent or recurrent, stable or variable, single- or multicomponent, perceived in the ears or «inside the head», uni- or bilateral with variable frequency and volume. In this study, tinnitus was considered in the context of non-delusional hypochondria, presented with disorders of the coenesthesiopathic spectrum and personality disorders. Syndrome-based approach divides these disorders as neurotic, overvalued, circumscripta, and senestopathic hypochondria. Based on the syndromal features of hypochondriacal symptoms, the overall sample of patients was divided into three groups: Group 1 with overvalued hypochondria and tinnitus; Group 2 with neurotic hypochondria and tinnitus; and Group 3 with senestopathic hypochondria and tinnitus. CONCLUSION: Idiopathic tinnitus, considered a sensory acoustic phenomenon, can present with multiple phenomenological variations and be a part of psychopathological symptoms related to various nosological categories: overvalued, neurotic, or senestopathic hypochondria syndromes within hypochondriacal disorder, recurrent depressive disorder, dysthymia, or schizotypal disorder/schizophrenia according to ICD-10.