Predictors of positive Self Rated Health in persons with tinnitus from the general population

Background:
Tinnitus is the perception of a sound without a corresponding external source. It is an annoying symptom, associated with decreased Health-Related Quality of Life (HR-QoL). Most research on tinnitus has been done on negative subjective rated health (SRH) in relation to tinnitus in clinical populations. However, most persons with tinnitus have positive SRH. We wanted to know what characterizes persons with tinnitus and positive SRH and what the contribution of tinnitus to SRH is in the general population.
Methods: 
We used data of a population-based cohort study of 124 490 adult participants, who answered the question: “Do you hear soughing or whistling in your ear or ears?”. Positive SRH was assessed using the RAND-36 item on self-rated health. Linear regression was used to determine predictors of positive SRH using variables assessing physical and mental health, impairment of hearing, life style, personality facets and demographic features in  participants with always tinnitus, and also in the complete population to evaluate the unique contribution of tinnitus to SRH.
Results: 
Prevalence of 6.4% was found for always hearing tinnitus, with 83.7% reporting positive SRH. Strongest predictors of SRH despite tinnitus were younger age, middle and higher education levels, good sleep quality, more social contacts, absence of irritable bowel syndrome and fibromyalgia and personality facets competence (high) and impulsivity (low). In the total population, we found a unique contribution of tinnitus to SRH, after adjustment for demographic features, physical and mental health history, lifestyle, and personality.
Discussion: 
Our findings contribute to increased understanding of resilience towards the negative consequences of tinnitus for the benefit of the patient population. Findings may implicate that early intervention should be targeted on improving sleep quality, preserve social contacts and enhance competence, i.e., experiencing oneself as being purposeful, sensible and effective. We propose early interventions in primary care using principals of positive psychology.