title: Internet-Delivered Cognitive-Behavior Therapy for Tinnitus: A Randomized Controlled Trial.
abstract: Tinnitus has a substantially negative impact on quality of life in up to 5% of the general population. Internet-based cognitive-behavioral treatment (iCBT) has been shown to be effective in a few trials. The aim of our study was to investigate iCBT for tinnitus by using a randomized controlled trial.
  
  
  
  Patients with severe tinnitus-related distress were randomly assigned to therapist-guided iCBT (n = 62) or to a moderated online discussion forum (n = 62). Standardized self-report measures for tinnitus-related distress (Tinnitus Handicap Inventory, Mini-Tinnitus Questionnaire) and associated symptoms (tinnitus acceptance, anxiety, depression, and insomnia) were assessed at pretreatment and posttreatment, 6-month-, and 1-year follow-up. Clinical significance was assessed with the Reliable Change Index.
  
  
  
  Multivariate analyses of variance revealed significant main effects for time, group, and interaction in favor of the iCBT group. With regard to tinnitus-related distress, the significant univariate interaction effects (time by group) were supported by large effect sizes (Tinnitus Handicap Inventory: g = 0.83, 95% confidence interval = 0.47-1.20; Mini-Tinnitus Questionnaire: g = 1.08, 95% confidence interval = 0.71-1.64). For the secondary outcomes, significant interactions with small to medium effect sizes were found. Within-group effects for the iCBT, from pretreatment to follow-up, were substantial in regard to tinnitus-related distress (1.38 ≤ d ≤ 1.81) and small to large for secondary outcomes (0.39 ≤ d ≤ 1.04).
  
  
  
  Using a randomized controlled trial design, we replicated prior findings regarding positive effects of Internet-delivered CBT on tinnitus-related distress and associated symptoms. Implementing iCBT for tinnitus into regular health care will be an important next step to increase access to treatment for patients with tinnitus.
  
  
  
  ClinicalTrials.gov, Identifier: NCT01205919.
authors: From the Division of Clinical Psychology and Psychotherapy, Department of Psychology (Weise, Kleinstäuber), Philipps-University Marburg, Marburg, Germany; Department of Behavioural Sciences and Learning (Weise, Andersson), Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; and Psychiatry Section, Department of Clinical Neuroscience (Andersson), Karolinska Institutet, Stockholm, Sweden.
authors: Cornelia
authors: C
authors: Weise
authors: Maria
authors: M
authors: Kleinstäuber
authors: Gerhard
authors: G
authors: Andersson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017216:Telemedicine / Q000379:methods*; D014012:Tinnitus / Q000628:therapy*; D055815:Young Adult