Hearing loss and hearing amplification: An important etiological factor in the assessment of mental disorders

Abstract

Listening is an important factor in cognitive maturation and development of speech as the most complex and most perfect symbol system in human communication. The hearing disorder in any period of life will have a significant impact on the overall personality development and can lead to disorders of mental functions. More or less severe hearing loss makes hearing- voice communication difficult, in cases when other treatment options have been exhausted (medicaments , surgical or combined) requires auditory amplification ie. The use of hearing aids. Audiologic and psychiatric diagnosis imposes a problem for observation of the hearing disability that are often disguised as a clinical picture of depression, anxiety, paranoia, mental and behavioral disorders which require team work of experts and education of doctors of all specialties. Besides the audiologic diagnostics application of the questionnaire Hearing Handicap Inventory (HHI) and the Tinnitus Handicap Inventory (THI) will allow Grading of hearing disabilities, emotional and social assessment of hearing loss as well as the real need for hearing rehabilitation. The existence of auditory handicap runs defense mechanisms aimed at maintaining self-esteem, which affects the formation of a special person with depleted identity that is characterized by: suspicion, distrust, limited control, egorigidity and impulsivity. Depression and anxiety are most often reactions to hearing handicap. Application of Beck's Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scales to assess depressive and anxiety features according to ICD-10 can significantly affect the early detection of these two disorders in persons with impaired hearing. The absence of sound has changed the perceptual reality there is insufficient emotional stimulation which gradually changes the personality of a person with hearing loss in terms of expression of psychological changes, changes in personality and behavior. The degree of change is correlated with age, indicating the need for hearing amplification with the aim of timely socialization, adaptation and integration into the social system. Given the social aspect of the problem as a primary source of difficulty, boundaries extend between the professions involved in team activities of perception and care for people with hearing loss and deafness.

Slušanje je važan faktor u kognitivnom sazrevanju i razvoju govora kao najsloženijeg i najsavršenijeg simboličkog sistema u ljudskoj komunikaciji. Poremećaj sluha u ma kom periodu života imaće značajne posledice na celokupni razvoj ličnosti i može dovesti do poremećaja psihičkih funkcija. Lakše ili teže oštećenje sluha koje otežava slušno-govornu komunikaciju, u slučajevima kada su druge mogućnosti lečenja iscrpljene (medikamentozno, hirurško ili kombinovano) zahteva slušnu amplifikaciju tj. primenu slušnog aparata. Audiološkoj i psihijatrijskoj dijagnostici se nameće problem zapažanja slušnog hendikepa koji je često zamaskiran kliničkom slikom depresije, anksioznosti, paranoje, mentalnim poremećijama i poremećajima ponašanja što zahteva timski rad stručnjaka kao i edukaciju lekara svih specijalnosti. Pored audiološke dijagnostike primena upitnika Hearing Handicap Inventory (HHI) i Tinnitus Handicap Inventory (THI) omogućiće stepenovanje slušnog hendikepa, procenu emocionalnog i socijalnog gubitka sluha kao i pravu potrebu za slušnom rehabilitacijom. Postojanje slušnog hendikepa pokreće mehanizme odbrane koji su usmereni na održavanje samopoštovanja, što utiče na formiranje posebnog sklopa ličnosti sa osiromašenim identiteom koju karakterišu: sumnjičavost, nepoverenje, ograničena kontrola, egorigidnost i impulzivnost. Depresija i anksioznost najčešće su reakcije na slušni hendikep. Primenom skala Beck's Depression Inventory (BDI) i Beck Anxiety Inventory (BAI) za procenu depresivnih i anksioznih obeležja prema MKB- 10 možemo značajno uticati na ranu detekciju ova dva poremećaja kod osoba oštećenog sluha. Odsustvom zvuka izmenjena je perceptivna realnost, prisutna nedovoljna emocionalna stimulacija što postepeno menja ličnost osobe oštećenog sluha u smislu ispoljavanja psihičkih promena, promena ličnosti i ponašanja. Stepen izraženosti promena je u korelaciji sa uzrastom što upućuje na neophodnost slušne amplifikacije sa ciljem pravovremene socijalizacije, adaptacije i integracije u društveni sistem. S obzirom na socijalni aspekt problema kao primarni izvor teškoća, proširuju se granice među profesijama uključenim u timsku delatnost sagledavanja i zbrinjavanja osoba sa nagluvošću i gluvoćom.