A randomised controlled study of mindfulness meditation versus relaxation therapy in the management of tinnitus

Arif, Muhammad; Sadlier, M; Rajenderkumar, Deepak; James, Judith A.; Tahir, Tayyeb A.

doi:10.1017/s002221511700069x

Cited by 42 publications

(65 citation statements)

References 30 publications

(29 reference statements)

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“…Three RCTs (35–37) one comparative controlled trial (13) and three cohort studies (24, 39, 40) were included in our review. Six out of the seven studies assessed the outcome only at the end of therapy, while one study had a follow up at 6 months (RCT) (36).…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review

et al. 2019

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Objectives: With this systematic review we aim to provide an overview of the evidence of the effect of Mindfulness Based Interventions (MBIs) on (1) tinnitus distress and (2) anxiety and/or depression in tinnitus patients.Methods: We conducted a systematic search in PubMed Medline, EMBASE and PsycInfo combining the terms and synonyms of “Tinnitus” and “Mindfulness.” The most recent search was performed on December 4th 2018. We wrote this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent authors identified studies, assessed the risk of bias and extracted data. Studies were considered eligible if they included adults with tinnitus, performed a protocolled MBI and measured tinnitus distress with validated questionnaires. Studies were appraised with either the Cochrane Risk of Bias tool or the MINORS criteria, depending on their design.Results: The systematic search yielded seven articles (425 patients). Three randomized controlled trials (RCTs), three cohort studies and one comparative controlled trial. Different types of MBIs, including MBCT and MBSR, were assessed with various questionnaires. Two of three RCTs showed a statistically significant decrease in tinnitus distress scores directly after treatment in the mindfulness group compared to the control group. Six of seven studies showed statistically significant decrease in tinnitus distress scores directly after mindfulness therapy. One of three RCTs showed a statistically significant improvement of depression questionnaire scores after MBI compared to the control group directly post treatment.Conclusions: A decrease of tinnitus distress scores in MBIs can be observed directly post-therapy based on moderate to high quality studies. This was found regardless of the heterogeneity of patients, study design, type of MBI and outcome assessment. Two out of three RCTs found clinically relevant decreases in tinnitus distress scores. No effect of MBIs was observed for depression and anxiety in tinnitus patients. Long term effects remain uncertain. Mindfulness may have a place in tinnitus therapy, although the long term effects need to be studied.

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Section: Resultsmentioning

confidence: 99%

“…Three other studies used different MBIs (13, 37, 38). Of these, Arif et al administered “mindfulness meditation” conducted by a single experienced therapist, which consisted of five (40 min) sessions over a period of 15 weeks.…”

Section: Resultsmentioning

confidence: 99%

The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review

et al. 2019

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“…The counseling was performed by the audiologists for each patient with tinnitus to acknowledge the patient's suffering, and to help the patient understand tinnitus, demystify the condition, and correct any false preconceptions (duration 1 h) [25]. Relaxation therapy consisted of home-based exercises, such as listening to music, avoiding unnecessary tension, and tai chi [26,27]. Patients were advised to execute this for two sessions of 30 min per day over a period of 8 weeks.…”

Section: Educational Counseling and Relaxation Therapymentioning

confidence: 99%

COVID-19 Associated Anxiety Enhances Tinnitus: A Case Control Study

Chen

Xia

et al. 2020

Preprint

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Background: The directional nature of the link between anxiety and tinnitus has not been verified. COVID-19 has added stress to involved residents and provided a good opportunity to discover if anxiety/stress plays a causative/promotive role to tinnitus. Methods: A retrospective research design was used to compare the tinnitus clinics between the patients in 2020 under COVID-19 and those from the matching period in 2019. While anxiety was quantified using the Zung’s Self-rating Anxiety Scale (SAS), tinnitus severity was evaluated using the Tinnitus Handicap Inventory (THI) questionnaire and the test of minimum masking level (MML). The assessments were repeated after two months of therapy with sound therapy + educational counselling (STEC) or EC alone. Results: A large increase in anxiety was evident in 2020 in both case rate and SAS. The treatment of both methods was less effective in 2020. SAS, THI and MML were all deteriorated after the EC alone treatment in 2020, while an improvement was seen in 2019. Discussion: The differences between years and between treatment methods suggest that EC alone could not counteract the stress by COVID-19 at all, and the stress, if not managed well, can significantly increase the severity of tinnitus and associated anxiety.Conclusions: By using the EC subgroup in virtual control, we conclude that anxiety can serve as a promoting factor to tinnitus. We believe that this is the first study report that confirm the causative/promotive role of anxiety on tinnitus

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“…Several research groups have investigated the effectiveness of MBIs, in either randomised controlled trials, cohort studies or a comparative controlled trial 27 28 30–35. The majority of observational studies show a decrease in tinnitus distress after MBI 27 28 30–34 36. Two out of three published randomised controlled trials show a statistically superior decrease of tinnitus distress compared with a control group of relaxation therapy directly after treatment 28 30 31.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of observational studies show a decrease in tinnitus distress after MBI 27 28 30–34 36. Two out of three published randomised controlled trials show a statistically superior decrease of tinnitus distress compared with a control group of relaxation therapy directly after treatment 28 30 31. One study demonstrated results at 6 months after therapy in which this positive result remained significant 28.…”

Section: Introductionmentioning

confidence: 99%

MinT-trial: Mindfulness versus cognitive behavioural therapy in Tinnitus patients: protocol for a randomised controlled, non-inferiority trial

Rademaker¹,

Stegeman²,

Lieftink

et al. 2020

BMJ Open

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IntroductionChronic subjective tinnitus is a condition that affects 5.1% to 42.7% of the population, depending on the definition and studied population. Evidence-based treatment options are limited. Cognitive Behavioural Therapy (CBT) has been proven effective to improve quality of life and to diminish tinnitus distress. Positive short-term effects of mindfulness-based interventions on tinnitus distress have been reported; however, the longer term effects remain to be studied.Methods and analysisWe designed a monocentre randomised controlled, non-inferiority trial to compare the effectiveness of mindfulness-based cognitive therapy (MBCT) and CBT in chronic tinnitus patients. Fifty-four patients (≥32 on the Tinnitus Functional Index (TFI), suffering from tinnitus for at least 6 months) will be included in the trial and randomised into one of two intervention groups. One group will receive MBCT, the other group will receive CBT. Our primary objective is to determine whether MBCT is non-inferior to (as good as) CBT on tinnitus distress (TFI) in chronic tinnitus patients at 12 months follow-up after end of therapy. Non-inferiority will be declared if the mean decrease in TFI score for MBCT is no worse than the mean decrease in TFI score in CBT, with statistical variability, with a margin of 13 points. Most secondary objectives (tinnitus severity of problem, tinnitus intrusiveness, quality of life, anxiety, depression, symptoms of psychopathology, perceived tinnitus complaints, coping style (mostly validated questionnaires)) are expected to show non-inferiority to MBCT compared with CBT. We expect a significant difference between MBCT and CBT for mindfulness awareness.Ethics and disseminationThis research protocol was approved by the Institutional Review Board of the UMC Utrecht (NL67838.041.18, V.4, April 2019). The trial results will be made accessible to the public in a peer-review journal.Trial registration numberNL7745.

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A randomised controlled study of mindfulness meditation versus relaxation therapy in the management of tinnitus

Abstract: This study suggests that although both mindfulness meditation and relaxation therapy are effective in the management of tinnitus, mindfulness meditation is superior to relaxation therapy.

Cited by 42 publications

References 30 publications

The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review

The Effect of Mindfulness-Based Interventions on Tinnitus Distress. A Systematic Review

COVID-19 Associated Anxiety Enhances Tinnitus: A Case Control Study

MinT-trial: Mindfulness versus cognitive behavioural therapy in Tinnitus patients: protocol for a randomised controlled, non-inferiority trial

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