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针对慢性失代偿性耳鸣患者的多模式认知行为住院治疗的不同结果

Differential outcome of a multimodal cognitive-behavioral inpatient treatment for patients with chronic decompensated tinnitus.

作者信息

Graul Joachim, Klinger Regine, Greimel Karoline V, Rustenbach Stephan, Nutzinger Detlev O

机构信息

Medical-Psychosomatic Clinic, Bad Bramstedt, Germany.

出版信息

Int Tinnitus J. 2008;14(1):73-81.

Abstract

We examined 179 inpatients with severe chronic tinnitus for tinnitus-related distress and psychological dysfunction after treatment. We conducted a prospective, nonrandomized, noncontrolled study. We calculated treatment outcome in tinnitus-related distress, depression, and somatic complaints by analysis of variance with repeated measurement at admission, at discharge, and at 3, 6, and 12 months after treatment. Additionally, on the basis of reduction in tinnitus-related distress, responders and nonresponders were determined. We compared the effects of treatment for both groups on tinnitus-related distress, depression, and somatic complaints. In our entire sample, tinnitus-related distress, depression, and somatic complaints decreased significantly at discharge. After discharge, all patients showed improvement for up to 12 months as compared to their condition at admission. Of the 179 severely distressed patients, 67% were found to have improved clinically at discharge, and 47% still benefited after 12 months. In comparison to the nonresponders, the responders displayed less depression, fewer physical complaints, and fewer body-related anxieties at each measuring point. The only distinguishing factors between responders and nonresponders were their age and the extent of their psychosocial stress. Limitations of the study and consequences for treatment of chronic tinnitus patients are discussed.

摘要

我们对179例重度慢性耳鸣住院患者治疗后的耳鸣相关困扰及心理功能障碍进行了检查。我们开展了一项前瞻性、非随机、非对照研究。通过在入院时、出院时以及治疗后3个月、6个月和12个月进行重复测量的方差分析,我们计算了耳鸣相关困扰、抑郁和躯体不适方面的治疗结果。此外,根据耳鸣相关困扰的减轻情况,确定了反应者和无反应者。我们比较了两组治疗对耳鸣相关困扰、抑郁和躯体不适的影响。在我们的整个样本中,耳鸣相关困扰、抑郁和躯体不适在出院时显著降低。出院后,与入院时相比,所有患者在长达12个月的时间里均有改善。在179例重度困扰患者中,67%在出院时临床症状有所改善,47%在12个月后仍有获益。与无反应者相比,反应者在每个测量点的抑郁程度更低、身体不适更少、与身体相关的焦虑更少。反应者和无反应者之间唯一的区别因素是他们的年龄和心理社会压力程度。本文讨论了该研究的局限性以及对慢性耳鸣患者治疗的影响。

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