Severe-to-profound hearing loss and mental health : initial evidence that cochlear implantation helps alleviate symptoms of anxiety and stress

Abstract

OBJECTIVES : Mental-health issues accounted for 418 million disability-adjusted life years in 2019, costing the world economy approximately $5 trillion. Untreated hearing loss is a well-known modifiable risk factor for mental-health issues, with severe-to-profound hearing loss having the largest impact. Therefore, treatment of severe-to-profound hearing loss, namely with cochlear implantation, could help to alleviate psychological distress. However, previous studies have failed to include comprehensive measures of mental health or adequate controls. The current study thus aimed to conduct a controlled, longitudinal investigation of how cochlear implantation affects depression, anxiety and stress levels. PARTICIPANTS : Participants were 87 adults assigned to conditions based on hearing status: normal hearing (n = 44), received cochlear implant (n = 26) or untreated hearing loss (n = 17). MAIN OUTCOMES MEASURES : The short-form Depression Anxiety Stress Scale was given at four timepoints (baseline, 3 months, 6 months, 12 months). Data were analysed using linear mixed-effects modelling. RESULTS : Results showed that cochlear implants helped to stabilise anxiety and stress symptoms, while depression symptoms were observed to worsen over time despite treatment. CONCLUSION : Our findings suggest that treatment of severe-to-profound hearing loss with cochlear implantation was associated with a lessening of anxiety and stress scores, although the clinical significance of such changes remains uncertain. Due to the current study's non-randomised treatment allocation, future randomised controlled trials are required for confirmation. The present findings help inform clinical and societal interventions for mental-health issues associated with hearing loss.

SUMMARY • Severe-to-profound hearing loss can negatively impact mental health. • We longitudinally assessed cochlear implants' influence on mental health. • A cochlear-implanted group was compared to untreated and normal controls with linear mixed-effects analyses. • Cochlear implantation was associated with lessening of anxiety and stress, but not depressive symptoms. • The current findings encourage post-implantation mental-health care for cochlear-implant recipients.