Conductive Hearing Loss Pathologies are Associated With Depression in the All of Us Research Program

Objective: Prior cross-sectional analysis suggests an association between conductive hearing loss (CHL) and depression. However, little is known about the potential impact of specific CHL pathologies on mood disorders. We investigate if there is an association between 3 potentially correctable causes of CHL (otosclerosis, cholesteatoma, and tympanic membrane perforation) and depressive disorders in a national cohort. Study design: Cross-sectional epidemiologic study. Setting: National Institutes of Health All of Us Research Program. Patients: Participants 18 years or older (n=363,302). Exposures were CHL pathologies defined by ICD-10 code: otosclerosis (H80.X), cholesteatoma (H71.X), and tympanic membrane perforation (H72.X). Main outcome measures: Outcomes were depressive disorders defined by ICD-10 code: major depressive disorder (MDD; F32-33) and dysthymia (F34.1). Multivariable regression, adjusting for potential confounders (age, sex, race, ethnicity, education, and smoking history), assessed the odds of depression in subjects with and without specific CHL pathologies. Results: The median age (interquartile range, range) was 57 years 41 to 69, 18 to 122; 62% identified as female. Controlling for covariates, the odds of MDD were 1.5 times (95% CI: 1.2-1.9; P <0.001) higher for those with otosclerosis compared with those without; no association was seen with dysthymia. The odds of MDD and dysthymia were 1.8 times (1.5 to 2.3; P <0.001) and 2.2 times (1.2 to 3.6; P =0.004) higher, respectively, for those with cholesteatoma, and 2.4 times (2.2 to 2.6; P <0.001) and 2.8 times (2.2 to 3.5; P <0.001) higher, respectively, for those with tympanic membrane perforation. Conclusions: In the All of Us dataset, all CHL pathologies were associated with MDD and most with dysthymia. This adds evidence that sensory deprivation from a purely peripheral process may impact mood.