The relationship between mental health conditions and hearing loss in low- and middle-income countries.

OBJECTIVE: Hearing loss can have far-reaching effects on social, emotional and cognitive development, but few studies have addressed the link with mental health conditions. We conducted a systematic review of the association between hearing loss and mental health conditions in low- and middle-income countries (LMICs). METHODS: We searched six electronic databases using predetermined criteria to retrieve original research reporting mental health in people with hearing loss. We considered quantitative studies measuring any type of mental health conditions according to the ICD10 classifications of 'Mental and behavioural disorders' in relation to any measure of hearing loss. We assessed risk of bias using a set of criteria according to the SIGN50 guidelines. RESULTS: We included 12 studies evaluating 35 604 people with hearing loss in 10 countries. Poorer mental health (measured as stress and anxiety, depression, and/or behavioural and emotional disorders) was more common among people with hearing loss compared to those without in 10 studies. One study found no difference in mental health outcomes between people with hearing, visual and no impairment. Another study reported that after hearing aids, those with severe hearing loss had significant improvement in psychosocial function, compared to no change among those without hearing loss. Overall, one study was judged to be high quality, seven medium quality and four low quality. CONCLUSIONS: Included studies showed a trend towards poorer mental health outcomes for people with hearing loss than for those without. However, our findings indicate that very few high-quality studies have been conducted in LMICs.