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基于互联网的引导自助与团体认知行为疗法治疗慢性耳鸣的随机对照试验。

Internet-based guided self-help versus group cognitive behavioral therapy for chronic tinnitus: a randomized controlled trial.

机构信息

Department of Clinical Psychology and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany.

出版信息

Psychother Psychosom. 2014;83(4):234-46. doi: 10.1159/000360705. Epub 2014 Jun 19.

Abstract

BACKGROUND

The aim of this randomized controlled trial was to investigate the effects of conventional face-to-face group cognitive behavioral therapy (GCBT) and an Internet-delivered guided self-help treatment (Internet-based CBT, ICBT) on tinnitus distress.

METHODS

A total of 128 adults with at least mild levels of chronic tinnitus distress were randomly assigned to GCBT (n = 43), ICBT (n = 41), or a web-based discussion forum (DF) that served as a control condition (n = 44). Standardized self-report measures [the Tinnitus Handicap Inventory (THI), Mini-Tinnitus Questionnaire (Mini-TQ), Hospital Anxiety and Depression Scale, Insomnia Severity Index and Tinnitus Acceptance Questionnaire] were completed at the pre- and post-assessments and at the 6-month follow-up.

RESULTS

Repeated-measures ANOVAs revealed significant time × group interaction effects on the primary outcomes (THI and Mini-TQ scores) in favor of both CBT interventions compared with the DF at post-assessment (0.56 ≤ g ≤ 0.93; all p ≤ 0.001). There were no significant differences between GCBT and ICBT (all p > 0.05) and the treatment effects remained stable at the 6-month follow-up.

CONCLUSIONS

This study provides evidence that ICBT might be an equally effective alternative to conventional CBT in the management of chronic tinnitus. Despite encouraging results, further research is necessary to determine the actual potential of ICBT as a viable alternative to CBT, and under which circumstances it is effective.

摘要

背景

本随机对照试验旨在研究传统面对面小组认知行为疗法(GCBT)和基于互联网的引导自助治疗(基于互联网的 CBT,ICBT)对耳鸣困扰的影响。

方法

共有 128 名至少有轻度慢性耳鸣困扰的成年人被随机分配到 GCBT(n=43)、ICBT(n=41)或作为对照条件的基于网络的讨论论坛(DF)(n=44)。在预评估和后评估以及 6 个月随访时,使用标准化自我报告量表[耳鸣残疾量表(THI)、耳鸣问卷(Mini-TQ)、医院焦虑和抑郁量表、失眠严重程度指数和耳鸣接受问卷]完成评估。

结果

重复测量方差分析显示,与 DF 相比,两种 CBT 干预在后评估时(0.56≤g≤0.93;所有 p≤0.001)在主要结局(THI 和 Mini-TQ 评分)上存在显著的时间×组交互效应。GCBT 和 ICBT 之间没有显著差异(所有 p>0.05),治疗效果在 6 个月随访时保持稳定。

结论

本研究提供了证据表明,ICBT 可能是 CBT 治疗慢性耳鸣的一种同等有效替代方法。尽管结果令人鼓舞,但仍需要进一步研究来确定 ICBT 作为 CBT 可行替代方法的实际潜力,以及在哪些情况下有效。

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