Increased prevalence of depressive symptoms and stress in patients with chronic bothersome tinnitus during the COVID-19 pandemic

Objectives The COVID-19 pandemic has been linked to various psychological and physical health consequences; however, its impact on tinnitus and associated psychological distress remains unexplored. This study evaluated the association between severity of chronic tinnitus and psychological outcomes, comparing these outcomes between the COVID-19 restriction period (2020) and the living-with-COVID-19 period (2022). Methods Data were drawn from the 8th (2020) and 9th (2022) Korea National Health and Nutrition Examination Survey. A total of 5,965 participants were classified into bothersome tinnitus (visual analogue scale [VAS] > 4), non-bothersome tinnitus (VAS ≤ 4), and non-tinnitus groups. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), with a cut-off score of 5. Complex sample analyses were performed using sampling weights. Results During the COVID-19 restriction period, the bothersome tinnitus group demonstrated significantly higher PHQ-9 scores and greater prevalence of depressive symptoms and high stress than the non-tinnitus group ( p < 0.001 for all) and the non-bothersome tinnitus group ( p < 0.05 for all). No significant differences were observed among groups during the living-with-COVID-19 period. Significant differences between the two periods were identified in the bothersome tinnitus group (PHQ-9, p = 0.048; depressive symptoms, p = 0.009; high stress, p = 0.039). Conclusion Bothersome chronic tinnitus was independently associated with higher prevalence of depressive symptoms and high stress during the COVID-19 restriction period. These findings highlight the importance of tinnitus severity assessment for identifying psychological vulnerability and the need for integrated tinnitus and psychological management, including non-face-to-face approaches, when in-person access is restricted.