National Cohort Data Suggests an Association Between Serious Mental Illness and Audiometric Hearing Loss

Isaac L Alter; Lauren H Tucker; Jacqueline M Dragon; Maeher R Grewal; Alice Saperstein; T Scott Stroup; Alice A Medalia; Justin S Golub

doi:10.1002/ohn.763

National Cohort Data Suggests an Association Between Serious Mental Illness and Audiometric Hearing Loss

Otolaryngol Head Neck Surg. 2024 Apr 12. doi: 10.1002/ohn.763. Online ahead of print.

Authors

Isaac L Alter¹, Lauren H Tucker¹, Jacqueline M Dragon¹, Maeher R Grewal², Alice Saperstein³, T Scott Stroup⁴, Alice A Medalia^{3

4}, Justin S Golub¹

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
² Department of Otolaryngology-Head and Neck Surgery, University of Utah-School of Medicine, Salt Lake City, Utah, USA.
³ Department of Psychiatry, Columbia University College of Physicians and Surgeons, Columbia University, New York, New York, USA.
⁴ New York State Psychiatric Institute, New York, New York, USA.

PMID: 38606639
DOI: 10.1002/ohn.763

Abstract

Objective: To explore whether there is an association between serious mental illness (SMI) and hearing loss (HL) among US Hispanic adults.

Study design and setting: Cross-sectional epidemiological study (Hispanic Community Health Study), including multicentered US volunteers.

Methods: Multivariable linear regressions were conducted to study the association between SMI and HL. Adjustments were made for potential confounders including age, sex, education, vascular disease (hypertension or diabetes mellitus), and cognition. SMI was defined by (1) antipsychotic medication classification and (2) the use of at least 1 antipsychotic medication specifically used to treat SMI in clinical psychiatric practice. HL was measured by pure tone audiometry.

Results: A total of 7581 subjects had complete data. The mean age was 55.2 years (SD = 7.5 years) and the mean pure tone average in the better ear was 16.8 dB (SD = 10.7 dB). A total of 194 (2.6%) subjects were taking a HCHS-defined antipsychotic and 98 (1.3%) were taking at least 1 antipsychotic specifically used to treat SMI. On multivariable regression, use of HCHS's classified antipsychotics was associated with 3.75 dB worse hearing (95% confidence interval [CI] = 2.36-5.13, P < .001) and use of antipsychotics specific for SMI was associated with 4.49 dB worse hearing (95% CI = 2.56-6.43, P < .001) compared to those not using antipsychotics.

Conclusion: SMI, as defined by either the use of HCHS-defined antipsychotics or the use of antipsychotic medication specific for SMI, is associated with worse hearing, controlling for potential confounders. Whether SMI contributes to HL, antipsychotic medication (through ototoxicity) contributes to HL, or whether HL contributes to SMI is unknown and warrants further investigation.

Keywords: Hispanic; antipsychotic; hearing loss; schizophrenia; serious mental illness.