Abstract: Background　With the development of society，geriatric depression has become a common mental disease affecting both physical and mental health of elderly population at home and abroad.Geriatric depression is often accompanied by tinnitus and other physical discomforts.Some studies have suggested that tinnitus partially correlates with depression and other emotional disorders，in particular，serious tinnitus may be positively correlated with the severity of depression，but the correlation between the two is not yet clear.Objective　To investigate the prevalence of tinnitus，and the correlation between disability caused by tinnitus and depression severity in elderly depressive patients.Methods　A total of 126 patients with geriatric depression diagnosed according to the DSM-Ⅴ were recruited from the Geriatric Psychology Ward and Clinic，the Fourth People's Hospital of Hefei from May to August 2019.Standardized questions on tinnitus were used to screen the prevalence of tinnitus，and by the results，the patients were divided into depression with tinnitus group and depression without tinnitus group.The Tinnitus Handicap Inventory（THI） was adopted to evaluate the severity of tinnitus disability.The Hamilton Rating Scale for Depression （HAMD） was adopted to evaluate the severity of depression.Pearson correlation analysis was used to estimate the correlation between tinnitus disability and depression severity.Results　The prevalence of tinnitus was 27.0%（34/126）.Compared with depression without tinnitus group，the average scale score（t=3.727，P<0.001） and subscale scores of somatization（t=3.330，P=0.001），cognitive impairment（t=2.961，P=0.003），insomnia（t=4.04，P<0.001） and despair （t=4.604，P<0.001）of HAM-D in depression with tinnitus group were significantly higher.Spearman correlation analysis showed that there was a positive correlation between tinnitus disability level and the severity of depression （r=0.377，P=0.033）.Pearson correlation analysis showed that the scale score of THI was positively correlated with that of HAMD（r=0.442，P=0.011）.Further analysis showed that the scale score of THI was positively correlated with the score of cognitive impairment（r=0.434，P=0.010），but showed no correlation with that of somatization，weight，daytime and nighttime changes，retardation，insomnia and despair.Conclusion　Geriatric depression often coexists with tinnitus.Tinnitus is highly prevalent in elderly people with depression，and tinnitus disability level partially and positively correlates with depression severity，suggesting that tinnitus may be a potential evaluation indicator for depression severity，that is，tinnitus may predict serious depressive symptoms，so clinicians should pay attention to symptoms of tinnitus during diagnosing and treating elderly depressive patients.

Key words: Depression, Tinnitus, Hamilton Depression Scale, Tinnitus Disability Scale, Aged

摘要： 背景　随着人类社会的不断发展，老年抑郁症已经成为影响我国乃至全世界老年人口生理和心理健康的常见心理疾病之一。老年抑郁症常伴发耳鸣等躯体不适，有研究认为耳鸣与情绪障碍如抑郁存在一定的联系，尤其是严重的耳鸣，被认为与抑郁程度呈正相关关系，但目前关于老年人群的二者之间的关联尚不明确。目的　探讨老年抑郁症患者耳鸣发生状况以及抑郁程度与耳鸣致残等级的相关性。方法　于2019年5—8月，收集合肥市第四人民医院老年心理科病房和门诊符合《精神疾病诊断与统计手册》第5版（DSM-Ⅴ）抑郁症诊断标准患者126例，采用耳鸣的标准化问题筛选抑郁症伴耳鸣患者，根据耳鸣发生情况将患者分为抑郁症耳鸣组与抑郁症非耳鸣组，采用耳鸣残障量表（THI）和汉密尔顿抑郁量表（HAMD）分别评估患者的耳鸣致残等级和抑郁程度，采用Pearson相关分析评估抑郁程度与耳鸣致残等级的相关性。结果　126例老年抑郁症患者中有34例（27.0%）发生耳鸣情况；与抑郁症非耳鸣组相比，抑郁症伴耳鸣组HAMD总分（t=3.727，P<0.001）、躯体化（t=3.330，P=0.001）、认知障碍（t=2.961，P=0.003）、睡眠障碍（t=4.040，P<0.001）和绝望感（t=4.604，P<0.001）因子得分升高；Spearman秩相关分析的结果显示耳鸣致残等级与抑郁程度之间呈正相关（r=0.377，P=0.033）；Pearson相关性分析显示THI得分与HAMD总分呈正相关（r=0.442，P=0.011），进一步分析THI得分与HAMD各因子之间的相关性，结果显示THI得分与认知障碍因子分呈正相关（r=0.434，P=0.010），而与躯体化、体质量、日夜变化、阻滞、睡眠障碍、绝望感之间无线性相关关系。结论　老年抑郁症常与耳鸣共病，在老年抑郁症群体里，耳鸣发生率高，老年抑郁症患者耳鸣致残等级与抑郁程度呈正相关，因此耳鸣可能是判断老年期抑郁严重程度的一个潜在指标，即当患者出现耳鸣症状时，可能预示着会出现较为严重的抑郁症状。提示临床医师在诊治过程中应关注患者耳鸣发生情况。

关键词: 抑郁, 耳鸣, 汉密尔顿抑郁量表, 耳鸣致残量表, 老年人