# Tinnitus among post-9/11 veterans: psychiatric comorbidity and associations with health and functional outcomes

## TL;DR

This study finds that tinnitus is common among post-9/11 Veterans and is linked to mental health and functional issues, even after accounting for PTSD and TBI.

## Contribution

The study identifies tinnitus as an independent contributor to pain and functional impairment in Veterans beyond PTSD and TBI.

## Key findings

- Tinnitus was present in 67.5% of post-9/11 Veterans and comorbid with PTSD and TBI in 35.6%.
- Tinnitus was associated with increased pain and functional impairment even after adjusting for PTSD and TBI.
- Tinnitus did not predict future worsening of pain or functional impairment.

## Abstract

Background: Tinnitus is common among Veterans and is associated with PTSD and traumatic brain injury (TBI).

Objective: To characterize tinnitus and examine the overlap of tinnitus, PTSD, and TBI and their relative associations with sleep disturbance, chronic pain, and cognitive and functional impairment.

Method: Participants were 735 primarily young (M = 34.7, SD = 9.1), male (90.2%) post-9/11 US Veterans. Hierarchical regressions were performed to determine whether additional variance in cross-sectional and longitudinal health outcomes was explained by tinnitus beyond PTSD and TBI.

Results: Tinnitus was common (67.5%) and evidenced substantial comorbidity with both PTSD and TBI in 35.6% of the sample. Tinnitus explained an additional 1.9-3% of the variance (both Δ p < .001) in pain (β = .184, p < .001) and functional impairment (β = .145, p < .001) after accounting for PTSD severity and number of TBIs and adjusting for multiple testing. PTSD significantly predicted all outcomes (βs = −.226 -.657, all ps < .001). Tinnitus showed stability over time but did not predict later pain or functional impairment.

Conclusions: Results suggest tinnitus is common among young treatment-seeking Veterans and highlight the need for future research aimed at reducing the toll of this chronic condition. Tinnitus should be evaluated alongside PTSD and TBI, as it may be associated with more negative health outcomes, even among those already at increased risk due to PTSD and TBI. Clinicians should be informed about best practices for managing tinnitus in efforts to improve health and well-being.

Tinnitus was endorsed by over two-thirds of this cohort of post-9/11 Veterans; it was comorbid with both PTSD and TBI in over one-third.Tinnitus was associated with incrementally worse self-reported pain and functional impairment, even after accounting for the effects of concurrent PTSD and TBI.Tinnitus was not related to future worsening of pain and functional impairment beyond baseline levels.

Tinnitus was endorsed by over two-thirds of this cohort of post-9/11 Veterans; it was comorbid with both PTSD and TBI in over one-third.

Tinnitus was associated with incrementally worse self-reported pain and functional impairment, even after accounting for the effects of concurrent PTSD and TBI.

Tinnitus was not related to future worsening of pain and functional impairment beyond baseline levels.