Table I.

Studies Included in the Review.

Study	Year	Country	Tinnitus Population Studied	Instrument	Patients with Tinnitus, n	Men, %	Mean Age or Range, y	Depression Prevalence, %	Quality Score
Adoga7	2008	Nigeria	All tinnitus patients who presented to ENT clinic.	HADS	92	45.7	36.0	17.4	4
Andersson14	2009	Sweden	Cochlear implant recipients who reported tinnitus	HADS	107	38.7	54.4	5.6	3
Barros Suzuki15	2016	Brazil	Patients with tinnitus complaints for > 1 y without improvement with drug therapies and no tinnitus treatment for at least 3 mo	HADS	10	50	41–78	10.0	3
Bartels16	2008	Netherlands	Consecutive patients with chronic tinnitus seen at ENT clinic	HADS ≥8	265	69.8	55.4	49.1	4
Belli8	2008	Turkey	Patients with tinnitus symptoms for at least 1 mo with no drug therapies for 3 mo prior to the study	SCI for DSM-III	85	45.6	38.4	5.6	4
Carlsson17	2015	Sweden	Patients with severe to profound hearing impairment who reported tinnitus	HADS ≥8	704	51	68.0	24.6	3
Crocetti18	2009	Italy	Patients with idiopathic tinnitus for at least 6 mo (exclusion criteria: Meniere’s disease and chronic pain)	BDI	108	66.7	48.0	13.0	4
Das19	2012	USA	Patients with nonpulsatile tinnitus of at least 6 mo (exclusion criteria: active diagnosis of any acute or chronic brain-related neurologic condition)	PHQ-9 ≥6	37	54	50.0	24.3	2
Fernandes20	2013	Brazil	Patients with orofacial pain and self-reported tinnitus	RDC/TMD	129	17.9	37.7	68.2	3
Folmer21	2008	USA	Consecutive patients with chronic tinnitus presenting to ENT clinic for initial appointment	aBDI	196	68.4	52.1	49.0	4
Gomaa22	2014	Egypt	Patients with subjective tinnitus associated with hearing loss presenting to ENT clinic	DASS	100	40	20–60	84	4
Granjeiro23	2013	Brazil	Patients with tinnitus and normal hearing (exclusion criteria: drug treatment for tinnitus in past 6 mo; tinnitus <6 mo; history of acoustic trauma, vascular disease, ear surgery, vestibular disorders, head trauma, and neurologic diseases; recent intake of ototoxic drugs and chemo-/radiotherapy).	BDI	68	45.6	36.8	66.2	3
Hilgenberg24	2012	Brazil	Patients with tinnitus receiving regular dental care (exclusion criteria: Ménière’s disease, history of noise exposure or ear surgery or infections; frequent use of headphones; abuse of ototoxic medication or substances, including fluoxetine and alcohol; and systemic diseases [eg, diabetes, hypertension] beyond control)	RDC/TMD	100	16	39.2	70.0	3
Jacques25	2013	Belgium	Patients with chronic tinnitus consulting an audiophonology center.	Clinical diagnosis of MDD (exact criteria unclear)	80	—	—	28.8	2
Langguth26	2007	Germany	Consecutive patients presenting to tinnitus clinic for tinnitus as their primary complaint	BDI ≥10	72	69.4	49.3	55.6	3
Meyer27	2014	Switzerland	Chronic tinnitus patients volunteering for EEG study	BDI	24	54.2	39.8	50.0	4
Michikawa28	2010	Japan	Patients who self-reported tinnitus in the past year in a community-based cross-sectional study	Self-report questiona	243	44.2	>65	33.7	2
Milhomem Rocha29	2015	Brazil	Concomitant tinnitus and musical hallucinations	SCID	16	12.5	61.4	68.8	3
Nondahl30	2011	USA	Patients who self-reported tinnitus in the past year from the Beaver Dam Offspring Study, an epidemiologic cohort study of aging	CES-D ≥ 16	345	51.3	50.8	24.6	4
Ooms11	2011	Belgium	Consecutive tinnitus patients seen at ENT clinic	BDI-II	136	64.7	49.1	33.1	4
Robinson31	2008	USA	Patients with self-reported tinnitus distress volunteering for cognitive-behavior therapy trial (exclusion criterion: inability to participate in group)	HRSD	65	52	55	24.6	4
Salonen32	2007	Finland	Subjects who responded to survey on hearing loss and reported tinnitus with or without annoyance	aBDI	343	41.2	70–85	19.0	3
Seo33	2016	Korea	Subjects who were part of KNHANES and reported experiencing tinnitus in the past year	Self-report questionb	3949	—	48.3	18.2	2
Shargorodsky34	2010	USA	Subjects who were part of NHANES and reported experiencing tinnitus in the past year.	WHO WMH-CIDI	2265	—	20–39	7.9	4
Sireci35	2012	Italy	Patients with tinnitus referred to audiology clinic	SCL 90-R	191	58.1	48.6	33.0	4
Trevis36	2016	Australia	Patients who self-identified as experiencing constant tinnitus for at least 3 mo	BDI-II	26	58	40.3	42.3	4
Vtillmann37	2013	Germany	Patients with chronic tinnitus responding to mailed questionnaires	HADS≥8	118	77.1	55.6	41.5	3
Zirke38	2013	Germany	Patients with tinnitus for at least 3 mo admitted to tinnitus center	CIDI	100	45	49.6	37.0	2

Abbreviations: aBDI, abbreviated Beck Depression Inventory; (0–4, no or minimal depression; 5–7, mild depression; 8–15, moderate depression; and ≥16, severe depression); BDI, Beck Depression Inventory; CES-D, Center for Epidemiologic Studies Depression Scale; CIDI, Composite International Diagnostic Interview (evaluated per criteria of the International Classification of Diseases, Tenth Revision and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition); DASS, Depression, Anxiety and Stress Scale; DSM-III, Diagnostic and Statistical Manual of Mental Disorders, Third Edition; EEG, electroencephalogram; ENT, ear, nose, and throat; HADS, Hospital Anxiety and Depression Scale (unless otherwise stated, >10); HRSD, Hamilton Rating Scale for Depression; KNHANES, Korea National Health and Nutrition Examination Survey; MDD, major depressive disorder; NHANES, National Health and Nutrition Examination Survey; PHQ-9, Patient Health Questionnaire-9; RDC/TMD, Research Diagnostic Criteria for Temporomandibular Disorders; SCI, Structured Clinical Interview; SCL 90-R, Symptom Checklist-90 R; WHO WMH-CIDI, World Health Organization World Mental Health Composite International Diagnostic Interview.

^aDepression was evaluated with the question “Do you feel sad, depressed, or miserable?”

^bDepression was evaluated with the question “Have you experienced a depressed mood for 2 or more continuous weeks during the previous year?”