Assessment of Ear Pathology in Schizophrenia


Vivek Chincholkar, Alkesh Patil

BACKGROUND An association between deafness and paranoid psychosis has often been reported. They are very few studies about middle ear disease being the etiological factor in some cases of schizophrenia. Also, there is opportunity to look for laterality of ear disease in schizophrenics. We wanted to study the association of ear pathology in schizophrenia and determine laterality of ear disease in schizophrenics. METHODS For this study 60 outdoor patients were selected of which one group contained 30 patients who were diagnosed with schizophrenia according to ICD-10. They underwent examination by ENT surgeons to look for any middle ear disease and other group of 30 patients were diagnosed as having middle ear disease by the same ENT surgeon which then were assessed for any psychotic symptoms. For rating of psychiatric symptoms, the Brief Psychiatric Rating Scale was administered. Later 3 groups were made of which first group contained subjects diagnosed with schizophrenia who had evidence of ear pathology, second group had those without any ear pathology and third group contained patients with middle ear disease who were assessed for any psychotic symptoms. RESULTS We found that schizophrenics with ear pathology had higher rates of paranoid psychosis as compared to those without ear pathology. Also, we found that in patients with middle ear disease, the hallucinations were restricted only to the affected ear, whereas in schizophrenics even though ear disease was unilateral, the hallucinations reported were always bilateral. CONCLUSIONS This study highlights the increased incidence of middle ear disease in schizophrenics and the importance of deafness in schizophrenics who do not have any ear complaints. Thus, a routine ENT examination and audiometry should be integral parts of psychiatric examination.