Effekte von Ablenkungs- und Entspannungstraining bei chronischem Tinnitus und Bedeutung der individuellen Fallkomplexität

Abstract

Effects of Distraction and Relaxation Training in Chronic Tinnitus and Impact of Individual Case Complexity. Background: In the case of complex chronic tinnitus many experts recommend inpatient rather than outpatient psychological treatment. Severe tinnitus-related distress and psychopathology are supposed to make treatment success difficult and are to be compensated by increased treatment efforts. Yet, evidence for the impact of case complexity on treatment effects is weak or equivocal. Patients and Methods: In a prospective randomized controlled trial with 139 tinnitus patients we investigated if previous findings on the effectiveness of an outpatient computer-aided and machine-assisted distraction and relaxation training (DRT) can be corroborated and to what extent case complexity is relevant for the short- to long-term success of the training. Treatment success was assessed by use of reliable and valid instruments for tinnitus-related distress, tinnitus coping and emotional distress not related to tinnitus. Furthermore, we analyzed whether outpatient DRT is also effective in patients with similarly complex tinnitus as in most of the inpatient population. The effect of DRT in these outpatients was contrasted with that of inpatient treatment. Results: DRT yielded a longlasting reduction of tinnitus-related distress and increased utilization of self-encouragement, relaxation, and attention diversion to cope with tinnitus. Intervention-specific changes in emotional distress not related to tinnitus were non-certifiable. There was no evidence that increased case complexity curtailed treatment success. The contrast of the effects of inpatient treatment and DRT indicated no advantage of the former. Conclusions: Recommending different therapeutic approaches according to tinnitus complexity seems rather eminence- than evidence-based. Further research on differential treatment indication and on dose-response relationship is required.

Evaluation of 5536 patients treated in an integrative outpatient tinnitus treatment center–immediate effects and a modeling approach for sustainability

“…These findings suggest that a single approach might not be as effective as a combined approach similar to what we applied in our research presented here. This is underpinned by several researchers who proposed the use of sound with educational elements and stress-reduction techniques supplemented with psychological and medical management as the most promising way to treat tinnitus [ 9 , 39 , 40 ].…”