Department of Psychiatry and Psychotherapy, University Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany.
Int J Environ Res Public Health. 2023 Mar 11;20(6):4982. doi: 10.3390/ijerph20064982.
Cognitive behavioral therapy (CBT) was shown to be effective in reducing tinnitus-related distress in numerous controlled trials. Real-world data from tinnitus treatment centers are an important addition to controlled trials for demonstrating the ecological validity of the results from the randomized controlled trials. Thus, we provided the real-world data of 52 patients participating in CBT group therapies during the time period from 2010 to 2019. The groups consisted of five to eight patients with typical CBT content such as counseling, relaxation, cognitive restructuring, attention training, etc. applied through 10-12 weekly sessions. The mini tinnitus questionnaire, different tinnitus numeric rating scales and the clinical global impression were assessed in a standardized way and were analyzed retrospectively. All outcome variables showed clinically relevant changes from before to after the group therapy, which were still evident in the follow-up visit after three months. Amelioration of distress was correlated to all numeric rating scales, including tinnitus loudness but not annoyance. The observed positive effects were in a similar range as effects of controlled and uncontrolled studies. Somewhat unexpected was the observed reduction in loudness, which was associated with distress and the missing association of changes in distress with annoyance as it is generally assumed that standard CBT concepts reduce annoyance and distress, but not tinnitus loudness. Apart from confirming the therapeutic effectiveness of CBT in real-world settings, our results highlight the need for a clear definition/operationalization of outcome measures when investigating psychological interventions of tinnitus.
认知行为疗法（CBT）在多项对照试验中已被证明可有效减轻耳鸣相关的困扰。耳鸣治疗中心的真实世界数据是对照试验的重要补充，可证明随机对照试验结果的生态有效性。因此，我们提供了 2010 年至 2019 年期间参加 CBT 团体治疗的 52 名患者的真实世界数据。这些组由五到八名患者组成，采用典型的 CBT 内容，如咨询、放松、认知重构、注意力训练等，通过 10-12 周的每周会议进行治疗。采用标准化方式评估迷你耳鸣问卷、不同的耳鸣数字评分量表和临床整体印象，并进行回顾性分析。所有的结果变量在团体治疗前后都显示出具有临床意义的变化，在三个月后的随访中仍然存在。困扰的改善与所有数字评分量表相关，包括耳鸣响度，但与烦恼无关。观察到的积极效果与对照和非对照研究的效果相似。有些出乎意料的是观察到的响度降低，它与困扰相关，而困扰的变化与烦恼无关，因为人们通常认为标准 CBT 概念可以减轻烦恼和困扰，但不能减轻耳鸣响度。除了证实 CBT 在真实环境中的治疗效果外，我们的结果还强调了在研究耳鸣的心理干预时，需要明确定义/操作化结果测量。
