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.