Tinnitus Handicap Inventory Printable Version

Print out this questionnaire and mark your answers next to each question.

Tinnitus Handicap Inventory (THI)

Points

		4	0	2
1.	Because of your Tinnitus is it difficult for you to concentrate?	Yes	No	Sometimes
2.	Does the loudness of your Tinnitus make it difficult for you to hear people?	Yes	No	Sometimes
3.	Does your Tinnitus make you angry?	Yes	No	Sometimes
4.	Does your Tinnitus make you confused?	Yes	No	Sometimes
5.	Because of your Tinnitus are you desperate?	Yes	No	Sometimes
6.	Do you complain a great deal about your Tinnitus?	Yes	No	Sometimes
7.	Because of your tinnitus do you have trouble falling asleep at night?	Yes	No	Sometimes
8.	Do you feel as though you cannot escape from your Tinnitus?	Yes	No	Sometimes
9.	Does your Tinnitus interfere with your ability to enjoy social activities (such as going out to dinner, to the cinema)?	Yes	No	Sometimes
10.	Because of your Tinnitus do you feel frustrated?	Yes	No	Sometimes
11.	Because of your Tinnitus do you feel that you have a terrible disease?	Yes	No	Sometimes
12.	Does your Tinnitus make it difficult to enjoy life?	Yes	No	Sometimes
13.	Does your Tinnitus interfere with your job or household responsibilities?	Yes	No	Sometimes
14.	Because of your Tinnitus do you find that you are often irritable?	Yes	No	Sometimes
15.	Because of your Tinnitus is it difficult for you to read?	Yes	No	Sometimes
16.	Does your Tinnitus make you upset?	Yes	No	Sometimes
17.	Do you feel that your Tinnitus has placed stress on your relationships with members of your family and friends?	Yes	No	Sometimes
18.	Do you find it difficult to focus your attention away from your Tinnitus and on to other things?	Yes	No	Sometimes
19.	Do you feel that you have no control over your Tinnitus?	Yes	No	Sometimes
20.	Because of your Tinnitus do you often feel tired?	Yes	No	Sometimes
21.	Because of your Tinnitus do you feel depressed?	Yes	No	Sometimes
22.	Does your Tinnitus make you feel anxious?	Yes	No	Sometimes
23.	Do you feel you can no longer cope with your Tinnitus?	Yes	No	Sometimes
24.	Does your Tinnitus get worse when you are under stress?	Yes	No	Sometimes
25.	Does your Tinnitus make you feel insecure?	Yes	No	Sometimes
	Total Score Per Column

Total Score: ______________

Total your points and then compare your total with the grade levels below.

0 - 16	Slight (Only heard in quiet environments)	Grade 1
18 - 36	Mild (Easily masked by environmental sounds and easily forgotten with activities)	Grade 2
38 - 56	Moderate (Noticed in presence of background noise, although daily activities can still be performed)	Grade 3
58 - 76	Severe (Almost always heard, leads to disturbed sleep patterns and can interfere with daily activities)	Grade 4
78 - 100	Catastrophic (Always heard, disturbed sleep patterns, difficulty with any activities)	Grade 5