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The Portuguese THI was correlated to the BDI with a Pearson correlation coefficient of 0.68, thus confirming its validity (16). The Italian version correlated well with the MOS 36-Item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS), providing evidence of good construct validity (17, 33, 34). THI-CH scores significantly correlated with the anxiety and depression scores of the HADS (20). The results of our confirmatory factor analysis seem to reinforce this doubt, because 10 out of the 25 items were loaded on more than one factor, and the items loading on the remaining three factors only partially Ibrutinib represented the subscales suggested by Newman et al (7). Factor analysis of the THI-P yielded similar results to the factor analyses performed on other versions of the THI. Factor analysis of THI-DK (13), the Italian version of the THI (17), THI-CM (19), and THI-CH (20) also revealed unifactorial structures. In the validation study for THI-DK, researchers stated that the three factors only partially matched the items in the original three subscales (13). Factor analysis of the Italian version of the THI indicated that the first, second, and third factors accounted for 35.9%, 7.8%, and 7.5% of the variance, respectively (17). Factor analysis of THI-CM demonstrated that the first, second, and third factors accounted for 38.9%, 6.5%, and 5.0% of the variance, respectively (19). Factor analysis of THI-CH demonstrated that the first, second, and third factors accounted for 41.9%, 6.87%, and 5.87% of the variance, respectively Selleck MK-2206 (20). Factor analysis of the original THI version performed in 2003 indicated that three factors could explain 52.8% of the variance, and adding more factors contributed little to the explanation of variance. Additionally, the majority TRIB1 of items were loaded on the first factor (35). The unifactorial structure of the original version was demonstrated. As was observed for the original version, the Persian version of THI does not appear to be affected by age, gender, or hearing loss. These findings were similar to those found by Mahmoudian et al (23). Our results showed moderate-to-strong relationships between the THI and depression as measured by the BDI. These findings are in agreement with earlier reports of a relationship between depression and tinnitus severity (36, 37). In contrast, only a weak relationship between THI and depression was observed for the original version. This difference between the Persian and the original sample may be explained by the higher mean THI-total scores (40.4 �� 26.5) of the Persian sample compared with the original US sample (THI-total: 24.4 �� 20.5). Strong-to-moderate correlations were also observed between the THI-P and the STAI questionnaires. Similar correlations were generally observed for THI-total scores and scores on the three subscales.