# Anxiety and Depression in Adolescents with Prelingual Hearing Loss: Prevalence and Risk Factors

## TL;DR

Adolescents with prelingual hearing loss show similar anxiety levels but possibly higher depression rates than their hearing peers, influenced more by social and communication factors than by hearing loss itself.

## Contribution

This study identifies psychosocial and communication factors as key predictors of emotional well-being in adolescents with prelingual hearing loss.

## Key findings

- Depression symptoms were more common in adolescents with hearing loss, though not statistically significant compared to hearing peers.
- Prosocial behavior and peer relations were protective factors for depression in hearing aid and cochlear implant users, respectively.
- Emotional symptoms were not linked to device type, hearing loss severity, or age at intervention.

## Abstract

Objectives: The aim of this study was to evaluate the prevalence of anxiety and depression symptoms and their predictors in 16–19-year-old adolescents with prelingual hearing loss (HL) who use spoken language. Methods: Self- and parent-reported symptoms were measured using RCADS-25 in 250 adolescents with HL (55.2% males; mean age = 17.1 years). A normal hearing (NH) peer group of 69 adolescents (56.5% males; mean age = 16.7 years) completed the self-reported RCADS-25. Key predictor variables included audiological factors, demographic factors, non-verbal IQ, language, communication, prosocial behaviour, and peer relations. Results: The proportion of adolescents with high self-reported anxiety was similar between HL and NH groups (~8%). Depression symptoms were more common in the HL group (11.2% self-reported, 15.8% parent-reported) than in the NH group (7.2%), but the difference was not statistically significant. Across informants, females had worse symptoms, but this association was no longer significant after accounting for communication difficulty. Among hearing aid users, higher prosocial behaviour was associated with fewer depression symptoms, while peer relations were a protective factor in cochlear implant users. Parent- and self-report congruence in symptom rating was modest (r = 0.56–0.68). Predictors of symptoms were consistent across informants, with parent happiness and socio-economic status additionally influencing parent-reported symptoms. Symptoms were unrelated to device type (hearing aid/cochlear implant), degree of hearing loss, or age at intervention. Adolescents with elevated symptoms also reported increased school absenteeism. Conclusions: Adolescents with HL reported anxiety at similar rates to NH peers but may have a higher prevalence of depression. Emotional well-being was influenced primarily by psychosocial and communication factors, not audiological characteristics.