Purpose: Persistent symptoms of chronic otitis media cause limitations in daily routine and social interactions, significantly influencing patients’ quality of life and mental health. The purpose of the study was to assess the intensity of depression, anxiety, and stress symptoms in patients with chronic otitis media and to examine if patient demographic data, characteristics, and reported symptoms of otitis influence reported depression, anxiety, and stress symptoms.

Material and Methods: The study included 316 adult patients diagnosed with unilateral or bilateral chronic otitis media with or without cholesteatoma. Patients underwent a complete otological, audiological and radiological assessment. Chronic otitis media questionnaire 12 (COMQ-12) was used to assess the impact of COM and Depression Anxiety Stress Scale 21 (DASS-21) was used for depression, anxiety, and stress assessment.

Results: Some levels of anxiety and stress were detected in 70.57% and 49.37% of the patients, respectively.  13.29% of the patients had scores indicating depression disorder. The mean value of the COMQ-12 questionnaire for this group of patients was 26.24 (SD±11.47) More intense symptoms of COM were significantly associated (p<0.05) with higher scores on DASS-21 subscales. Multivariate logistic regression analysis indicated that significant positive predictors of higher anxiety scores were pure tone average (PTA) on the better and worse hearing ear (p<0.05). Drainage from the ear, hearing problems at home, and tinnitus were significant positive predictors of a higher DASS-depression score. (p<0.05).

Conclusion: The study confirmed a positive correlation between reported levels of anxiety, depression, and stress, the severity of COM symptoms, and quality of life. Levels of hearing in the better and worse hearing ear were significant positive predictors of anxiety and stress in patients with COM.

Study Design and Population

A cross-sectional study was conducted on 316 patients diagnosed with unilateral or bilateral COM with or without cholesteatoma. Exclusion criteria were as follows: previously surgically treated COM with cholesteatoma (squamous) or without cholesteatoma (mucosal), the existence of any other otorhinolaryngology disease, and previous diagnosis of anxiety, depression, or any other psychiatric disorders. 

In addition, the questionnaires were administered to a normative reference control group of 110 chosen among volunteers (medical students, hospital staff, and families of the authors). Each subject was examined by the authors (two otorhinolaryngologists and one psychiatrist) prior to filling out the questionnaires. Subjects who had pathological findings on their otorhinolaryngological exam, who had a history of COM, previous ear surgery, or had any other otorhinolaryngology disease were excluded from the study. Also, subjects with previous diagnoses of anxiety, depression, or any other psychiatric diseases, or who were prescribed psychiatric medication, were excluded from the study.

Clinical examinations and symptoms assessment

All patients underwent complete otorhinolaryngology examination, otomicroscopy, pure-tone audiometry of both ears with air- and bone-conduction hearing levels and computerized tomography (CT) of the temporal bone. The normative reference volunteer group underwent otorhinolaryngology examination, otomicroscopy, pure-tone audiometry. Other data acquired from the patients and their medical history included age, sex, marriage/partnership status, level of education (primary school, secondary school, post-secondary education, higher education), and the duration of the disease (duration of up to 1 year, from 1 to 3 years, from 3 to 5 years, duration over 5 years).

The COMQ-12 [11] was used to assess the impact of the disease. 

The DASS-21[12,13] was used to assess depression, anxiety, and stress symptoms. 

For the purpose of this data set, de-identification of data was done in order not to compromise participant privacy, according to the Ethical board decision. 

There are missing values in the data set.