Mindfulness-Based Cognitive Therapy as a Treatment for Chronic Tinnitus: A Randomized Controlled Trial

被引:55
|
作者
McKenna, Laurence [1 ]
Marks, Elizabeth M. [1 ,3 ]
Hallsworth, Christopher A. [3 ]
Schaette, Roland [2 ]
机构
[1] Royal Natl Throat Nose & Ear Hosp, 330 Grays Inn Rd, London WC1X 8DA, England
[2] UCL, Ear Inst, London, England
[3] Univ Bath, Bath, Avon, England
关键词
Tinnitus; Mindfulness-based cognitive therapy; Relaxation; HOSPITAL ANXIETY; AVOIDANCE; SCALE; FEAR;
D O I
10.1159/000478267
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background: 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. Methods: 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. Results: 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. Conclusions: 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. (c) 2017 S. Karger AG, Basel
引用
收藏
页码:351 / 361
页数:11
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