title: [Integrated intensive treatment of tinnitus: decrease of the tinnitus-related distress during a one-year follow-up study].
abstract: OBJECTIVE
  The therapy of the chronic tinnitus is aimed at improving the way patients cope with their tinnitus and at reducing the tinnitus-related distress. The present study investigated the changes of psychometric parameters that occurred in patients with chronic tinnitus after 7-days outpatient multidisciplinary therapy. The changes were monitored for up to 1 year in order to evaluate the long-term efficiency.
  
  
  METHODS
  Main emphasis of the intensive tinnitus therapy applied was placed on tinnitus habituation and on teaching the patients how to apply coping strategies. The main elements of the multimodal concept included progressive muscle relaxation according to Jacobson, physiotherapy, educative seminars, training of selective attention and, lastly, the change of judgment, attitude and behaviour towards tinnitus. Psychometric parameters and tinnitus-related distress were assessed prior to and after the therapy (at 3, 6 and 12 months) using the tinnitus questionnaire (TQ) according to Goebel and Hiller. Furthermore, subjects waiting for therapy (waiting list) were recruited to the control group and compared with the therapy group which had received therapy 3 months earlier.
  
  
  RESULTS
  The therapy group showed a significant reduction of the TQ total score after 3 months as compared to the control group. Moreover, we observed a long-term, progressive positive outcome during the one-year follow-up. The TQ total score was reduced by 10.9 points. There was an obvious decrease of the emotional and cognitive distress as well as of the intrusiveness of tinnitus, as per evaluation of TQ subscales.
  
  
  CONCLUSIONS
  The outpatient intensive multidisciplinary tinnitus therapy with long-term aftercare has proved to be an effective method in the treatment of patients with chronic tinnitus. The outpatient setting enables the instant implementation of strategies learned during therapy in the patients' everyday life.
authors.affiliation: Klinik für Hals-Nasen-Ohren-Heilkunde, Tinnituszentrum, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, Berlin. birgit.mazurek@charite.de
authors.forename: B
authors.initials: B
authors.lastname: Mazurek
authors.forename: C
authors.initials: C
authors.lastname: Seydel
authors.forename: H
authors.initials: H
authors.lastname: Haupt
authors.forename: A
authors.initials: A
authors.lastname: Szczepek
authors.forename: B F
authors.initials: BF
authors.lastname: Klapp
authors.forename: T
authors.initials: T
authors.lastname: Schrom
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002908:Chronic Disease; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods* / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control*; D014012:Tinnitus / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome