Psychother Psychosom. 2017;86(6):351-361. doi: 10.1159/000478267. Epub 2017 Nov 3.
Tinnitus is experienced by up to 15% of the population and can lead to significant disability and distress. There is rarely a medical or surgical target and psychological therapies are recommended. We investigated whether mindfulness-based cognitive therapy (MBCT) could offer an effective new therapy for tinnitus.
This single-site randomized controlled trial compared MBCT to intensive relaxation training (RT) for chronic, distressing tinnitus in adults. Both treatments involved 8 weekly, 120-min sessions focused on either relaxation (RT) or mindfulness meditation (MBCT). Assessments were completed at baseline and at treatment commencement 8 weeks later. The primary outcomes were tinnitus severity (Tinnitus Questionnaire) and psychological distress (Clinical Outcomes in Routine Evaluation - Non-Risk, CORE-NR), 16 weeks after baseline. The analysis utilized a modified intention-to-treat approach.
A total of 75 patients were randomly allocated to MBCT (n = 39) or RT (n = 36). Both groups showed significant reductions in tinnitus severity and loudness, psychological distress, anxiety, depression, and disability. MBCT led to a significantly greater reduction in tinnitus severity than RT, with a mean difference of 6.3 (95% CI 1.3-11.4, p = 0.016). Effects persisted 6 months later, with a mean difference of 7.2 (95% CI 2.1-2.3, p = 0.006) and a standardized effect size of 0.56 (95% CI 0.16-0.96). Treatment was effective regardless of initial tinnitus severity, duration, or hearing loss.
MBCT is effective in reducing tinnitus severity in chronic tinnitus patients compared to intensive RT. It also reduces psychological distress and disability. Future studies should explore the generalizability of this approach and how outcome relates to different aspects of the intervention.
耳鸣影响了多达 15%的人群，并可能导致显著的残疾和痛苦。很少有医学或手术靶点，因此推荐心理治疗。我们研究了正念认知疗法（MBCT）是否可以为慢性、困扰性耳鸣患者提供一种有效的新疗法。
这项单站点随机对照试验比较了 MBCT 与强化放松训练（RT）治疗成年人慢性、困扰性耳鸣。两种治疗都包括 8 周每周 120 分钟的课程，分别侧重于放松（RT）或正念冥想（MBCT）。在基线和 8 周后治疗开始时进行评估。主要结局是耳鸣严重程度（耳鸣问卷）和心理困扰（常规评估中的临床结局-非风险，CORE-NR），在基线后 16 周评估。分析采用了改良的意向治疗方法。
共有 75 名患者被随机分配到 MBCT 组（n = 39）或 RT 组（n = 36）。两组患者的耳鸣严重程度和响度、心理困扰、焦虑、抑郁和残疾均显著降低。MBCT 导致耳鸣严重程度的降低明显大于 RT，平均差异为 6.3（95%置信区间 1.3-11.4，p = 0.016）。6 个月后效果持续存在，平均差异为 7.2（95%置信区间 2.1-2.3，p = 0.006），标准化效应大小为 0.56（95%置信区间 0.16-0.96）。无论初始耳鸣严重程度、持续时间或听力损失如何，治疗都有效。
与强化 RT 相比，MBCT 可有效降低慢性耳鸣患者的耳鸣严重程度。它还降低了心理困扰和残疾。未来的研究应探索这种方法的普遍性以及结果与干预的不同方面的关系。
