Whilst some studies have identified gender-specific differences, there is no consensus about gender-specific determinants for prevalence rates or concomitant symptoms of chronic tinnitus such as depression or anxiety. However, gender-associated differences in psychological response profiles and coping strategies may differentially affect tinnitus chronification and treatment success rates. Thus, understanding gender-associated differences may facilitate a more detailed identification of symptom profiles, heighten treatment response rates, and help to create access for vulnerable populations that are potentially less visible in clinical settings. Our research questions are: RQ1: how do male and female tinnitus patients differ regarding tinnitus-related distress, depression severity, and treatment response, RQ2: to what extent are answers to questionnaires administered at baseline associated with gender, and RQ3: which baseline questionnaire items are associated with tinnitus distress, depression, and treatment response, while relating to one gender only? In this work, we present a data analysis workflow to investigate gender-specific differences in N = 1,628 patients with chronic tinnitus (828 female, 800 male) who completed a 7-day multimodal treatment encompassing cognitive behavioral therapy (CBT), physiotherapy, auditory attention training, and information counseling components. For this purpose, we extracted 181 variables from 7 self-report questionnaires on socio-demographics, tinnitus-related distress, tinnitus frequency, loudness, localization, and quality as well as physical and mental health status. Our workflow comprises (i) training machine learning models, (ii) a comprehensive evaluation including hyperparameter optimization, and (iii) post-learning steps to identify predictive variables. We found that female patients reported higher levels of tinnitus-related distress, depression and response to treatment (RQ1). Female patients indicated higher levels of tension, stress, and psychological coping strategies rates. By contrast, male patients reported higher levels of bodily pain associated with chronic tinnitus whilst judging their overall health as better (RQ2). Variables measuring depression, sleep problems, tinnitus frequency, and loudness were associated with tinnitus-related distress in both genders and indicators of mental health and subjective stress were found to be associated with depression in both genders (RQ3). Our results suggest that gender-associated differences in symptomatology and treatment response profiles suggest clinical and conceptual needs for differential diagnostics, case conceptualization and treatment pathways.

中文翻译：

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慢性耳鸣患者的性别差异——基线特征和治疗效果

虽然一些研究已经确定了性别差异，但对于流行率或慢性耳鸣的伴随症状（如抑郁或焦虑）的性别特异性决定因素尚未达成共识。然而，心理反应概况和应对策略中的性别相关差异可能会不同地影响耳鸣时间和治疗成功率。因此，了解与性别相关的差异可能有助于更详细地识别症状特征，提高治疗反应率，并有助于为临床环境中可能不太明显的脆弱人群创造机会。我们的研究问题是： RQ1：男性和女性耳鸣患者在耳鸣相关的痛苦、抑郁严重程度和治疗反应方面有何不同，RQ2：基线问卷的答案在多大程度上与性别相关，以及 RQ3：哪些基线问卷项目与耳鸣困扰、抑郁和治疗反应相关，而仅与一种性别相关？在这项工作中，我们提出了一个数据分析工作流程来调查 N = 1,628 名慢性耳鸣患者（828 名女性，800 名男性）的性别差异，这些患者完成了 7 天的多模式治疗，包括认知行为治疗 (CBT)、物理治疗、听觉注意力训练和信息咨询组成部分。为此，我们从 7 份关于社会人口统计学、耳鸣相关困扰、耳鸣频率、响度、定位和质量以及身心健康状况的自我报告问卷中提取了 181 个变量。我们的工作流程包括 (i) 训练机器学习模型，(ii) 包括超参数优化在内的综合评估，以及 (iii) 识别预测变量的后学习步骤。我们发现女性患者报告的与耳鸣相关的痛苦、抑郁和对治疗的反应水平较高 (RQ1)。女性患者表现出更高水平的紧张、压力和心理应对策略率。相比之下，男性患者报告与慢性耳鸣相关的身体疼痛程度更高，同时认为他们的整体健康状况更好（RQ2）。测量抑郁症、睡眠问题、耳鸣频率和响度的变量与两性耳鸣相关的痛苦相关，并且发现心理健康和主观压力指标与两性的抑郁症相关（RQ3）。