Manchaiah Vinaya, Andersson Gerhard, Beukes Eldré W, Fagelson Marc A, Swanepoel De Wet, Maidment David
Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA.
UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA.
Clin Pract. 2025 Mar 27;15(4):69. doi: 10.3390/clinpract15040069.
To examine the changes in perceived tinnitus sound qualities following internet-based cognitive behavioral therapy (ICBT) for tinnitus. This study was embedded within several clinical trials evaluating the efficacy of ICBT and used a quasi-experimental design (N = 152). Participants completed a series of online questionnaires, including measures of tinnitus sound qualities (Tinnitus Qualities and Impact Questionnaire; TQIQ), tinnitus severity (Tinnitus Functional Index; TFI), anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-9; PHQ-9), insomnia (Insomnia Severity Index; ISI), and health-related quality of life (EQ-5D-5L Visual Analog Scale; VAS). Data were analyzed using a range of parametric and non-parametric statistics, and Cohen's effect sizes were reported. There were no significant differences between the intervention and control groups in sociodemographic and clinical variables at baseline except for anxiety and depression symptoms, which were higher in the intervention group. A statistically significant reduction in tinnitus severity, anxiety, depression, and insomnia was noted post-intervention, with small-to-moderate effect sizes. Statistically significant improvements were also noted for the TQIQ (overall and all subscales) following ICBT compared to the no-intervention group ( ≤ 0.028), all with small-to-large effect sizes, except for the loud sounds subscale and for participants with a TQIQ < 38 at baseline, or "mild" perceived qualities of tinnitus ( ≥ 0.136). A significantly greater proportion of participants in the intervention group had minimum clinically important differences (38%) on the TQIQ compared to the no-intervention group (9%). ICBT can lead to changes in the perceived qualities of tinnitus sound in addition to reducing tinnitus severity and other aspects, such as anxiety, depression, and insomnia. While these findings are preliminary, they highlight that tinnitus distress and perception may be related. However, the study has several limitations including a lack of audiological variables and objective measures. For this reason, the study results must be viewed with caution and must be treated as preliminary.
为研究基于互联网的耳鸣认知行为疗法（ICBT）后耳鸣感知音质的变化。本研究纳入了多项评估ICBT疗效的临床试验，并采用了准实验设计（N = 152）。参与者完成了一系列在线问卷，包括耳鸣音质测量（耳鸣特质与影响问卷；TQIQ）、耳鸣严重程度（耳鸣功能指数；TFI）、焦虑（广泛性焦虑障碍-7；GAD-7）、抑郁（患者健康问卷-9；PHQ-9）、失眠（失眠严重程度指数；ISI）以及健康相关生活质量（EQ-5D-5L视觉模拟量表；VAS）。使用一系列参数和非参数统计方法对数据进行分析，并报告了科恩效应量。除焦虑和抑郁症状外，干预组和对照组在基线时的社会人口统计学和临床变量无显著差异，干预组的焦虑和抑郁症状更高。干预后耳鸣严重程度、焦虑、抑郁和失眠有统计学意义的降低，效应量为小到中等。与无干预组相比，ICBT后TQIQ（总体及所有子量表）也有统计学意义的改善（≤0.028），除大声子量表以及基线时TQIQ < 38或耳鸣感知特质为“轻度”（≥0.136）的参与者外，所有效应量均为小到大。与无干预组（9%）相比，干预组中TQIQ达到最小临床重要差异的参与者比例显著更高（38%）。ICBT除了降低耳鸣严重程度和其他方面，如焦虑、抑郁和失眠外，还可导致耳鸣感知音质的变化。虽然这些发现是初步的，但它们突出了耳鸣困扰和感知可能相关。然而，该研究有几个局限性，包括缺乏听力学变量和客观测量。因此，必须谨慎看待研究结果，且应将其视为初步结果。
