title: Differential outcome of a multimodal cognitive-behavioral inpatient treatment for patients with chronic decompensated tinnitus.
abstract: We examined 179 inpatients with severe chronic tinnitus for tinnitus-related distress and psychological dysfunction after treatment. We conducted a prospective, nonrandomized, noncontrolled study. We calculated treatment outcome in tinnitus-related distress, depression, and somatic complaints by analysis of variance with repeated measurement at admission, at discharge, and at 3, 6, and 12 months after treatment. Additionally, on the basis of reduction in tinnitus-related distress, responders and nonresponders were determined. We compared the effects of treatment for both groups on tinnitus-related distress, depression, and somatic complaints. In our entire sample, tinnitus-related distress, depression, and somatic complaints decreased significantly at discharge. After discharge, all patients showed improvement for up to 12 months as compared to their condition at admission. Of the 179 severely distressed patients, 67% were found to have improved clinically at discharge, and 47% still benefited after 12 months. In comparison to the nonresponders, the responders displayed less depression, fewer physical complaints, and fewer body-related anxieties at each measuring point. The only distinguishing factors between responders and nonresponders were their age and the extent of their psychosocial stress. Limitations of the study and consequences for treatment of chronic tinnitus patients are discussed.
authors.affiliation: Medical-Psychosomatic Clinic, Bad Bramstedt, Germany. jgraul@schoen-kliniken.de
authors.forename: Joachim
authors.initials: J
authors.lastname: Graul
authors.forename: Regine
authors.initials: R
authors.lastname: Klinger
authors.forename: Karoline V
authors.initials: KV
authors.lastname: Greimel
authors.forename: Stephan
authors.initials: S
authors.lastname: Rustenbach
authors.forename: Detlev O
authors.initials: DO
authors.lastname: Nutzinger
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011446:Prospective Studies; D012803:Sick Role; D013001:Somatoform Disorders / Q000523:psychology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000523:psychology / Q000534:rehabilitation*