A modified version of tinnitus retraining therapy: Observing long-term outcome and predictors
A modified version of tinnitus retraining therapy: Observing long-term outcome and predictors
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DOI：
10.1159/000093526
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发表时间：
2006-01-01
影响因子：
1.6
通讯作者：
Klapp, Burghard F.
中科院分区：
文献类型：
--
作者：
Mazurek, Birgit;Fischer, Franziska;Klapp, Burghard F.
德国的耳鸣再训练疗法(TRT)不仅包括指导性咨询和声音治疗，还包括压力管理和兼职心理治疗。本研究的目的是调查这种改良的TRT对某些与耳鸣相关的痛苦方面的影响，以及可能预测治疗结果的变量。对在Charite耳鸣中心接受TRT门诊治疗的92名患者的临床资料进行了一年多的回顾性评估。治疗结果通过耳鸣相关痛苦的特定区域的变化来确定，并通过耳鸣问卷进行评估。常规测听检查耳鸣的测听频率和响度的变化。耳鸣问卷总分在1年后显著降低。受影响严重的耳鸣患者(失代偿性耳鸣)比受影响较轻的患者(代偿性耳鸣)获益更多。在指导性心理治疗的病例中，在TRT期间利用心理治疗的患者改善显著，但对于中断或取消指导性心理治疗的患者则没有显著改善。耳鸣特有的痛苦区域的变化在情绪和认知痛苦和侵扰性的量表上最为明显。失代偿性耳鸣患者的睡眠障碍、听觉障碍和躯体主诉均有明显改变。对于慢性耳鸣患者，改良的TRT可能会显著改善某些与耳鸣相关的症状，如情绪和认知困扰以及侵入性。尤其是患有严重耳鸣痛苦的患者可以利用治疗。仔细的心理治疗诊断和治疗，以及在必要时，使用心理治疗的动机似乎是严重心身共病患者治疗成功的基本先决条件。版权所有(C)2006 S.Karger AG，巴塞尔。
Tinnitus retraining therapy ( TRT) in Germany includes not only directive counseling and sound therapy but also stress management and facultative psychotherapeutic treatment. The aim of the present study was to investigate the impact of this modified version of TRT on certain tinnitus-related aspects of distress and variables that may predict treatment outcome. Clinical data from 92 patients undergoing outpatient TRT in the Charite Tinnitus Centre were evaluated retrospectively over 1 year. Treatment outcome was defined by changes in specific areas of tinnitus-related distress and assessed by the Tinnitus Questionnaire. Changes in audiometric frequency and loudness of tinnitus were examined by regular audiometric testing. The overall Tinnitus Questionnaire score was significantly reduced after 1 year. Severely affected tinnitus sufferers ( decompensated tinnitus) profited more than less affected patients ( compensated tinnitus). In cases of indicated psychotherapy, improvement was significant for the patients who took advantage of psychotherapeutic treatment during TRT but was not significant for those who interrupted or dismissed an indicated psychotherapy. Changes in tinnitus-specific areas of distress were most pronounced in the scales for emotional and cognitive distress and intrusiveness. Significant changes in sleep disturbances, auditory perceptual difficulties and somatic complaints were observed in patients with decompensated tinnitus. In patients with chronic tinnitus, modified TRT may lead to significant subjective improvement in certain tinnitus-related symptoms like emotional and cognitive distress and intrusiveness. Particularly patients suffering from severe tinnitus distress take advantage of therapy. Careful psychotherapeutic diagnostics and therapies and, if necessary, motivation to make use of psychotherapy seem to be essential preconditions for therapeutic success in patients with severe psychosomatic comorbidity. Copyright (C) 2006 S. Karger AG, Basel.