Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Sweden.
Clin Psychol Rev. 2011 Jun;31(4):545-53. doi: 10.1016/j.cpr.2010.12.006. Epub 2010 Dec 23.
Tinnitus is defined as a sound in the ear(s) and/or head without external origin and is a serious health concern for millions worldwide. The aim of the present study was to determine whether Cognitive Behavior Therapy (CBT) is effective in reducing distress associated with tinnitus. Randomized, controlled trials that assessed the efficacy of CBT for tinnitus-related distress in adults were identified by searching electronic databases (PsychINFO, PubMed, the Cochrane Library), and by manual searches. Fifteen studies (total of 1091 participants) were included in the meta-analysis. CBT compared with a passive and active control at post-assessment yielded statistically significant mean effect sizes for tinnitus-specific measures (Hedges's g=0.70, and Hedges's g=0.44, respectively). The average weighted pre-to-follow-up effect size for the CBT group suggested that these effects were maintained over time. Smaller but yet statistically significant effects of CBT were found for mood outcome measures. Characteristics of the studies were unrelated to effect sizes. Methodological rigor, publication bias, and a series of sensitivity analyses did not influence the findings. The results suggest that CBT is an effective treatment of tinnitus distress. However, caution is warranted given that few large-scale, well-controlled trials were identified.
耳鸣定义为耳内或头部的无外部来源的声音，是全球数百万人严重的健康问题。本研究的目的是确定认知行为疗法（CBT）是否能有效减轻与耳鸣相关的痛苦。通过搜索电子数据库（心理信息、PubMed、Cochrane 图书馆）和手动搜索，确定了评估 CBT 对成年人耳鸣相关痛苦疗效的随机对照试验。Meta 分析纳入了 15 项研究（共 1091 名参与者）。CBT 与被动和主动对照组在评估后相比，耳鸣特定测量的平均效应大小具有统计学意义（Hedges's g=0.70 和 Hedges's g=0.44）。CBT 组的平均加权预随访效应大小表明，这些效果随时间保持。CBT 对情绪结果测量的效果较小，但仍具有统计学意义。研究的特征与效应大小无关。方法学严谨性、发表偏倚和一系列敏感性分析并未影响研究结果。结果表明，CBT 是治疗耳鸣痛苦的有效方法。然而，鉴于仅确定了少数大规模、对照良好的试验，因此需要谨慎。
