Researchers from Sweden’s Uppsala University demonstrate in a randomized, clinical trial that annoyance from tinnitus (ringing in the ears) can be significantly reduced through cognitive behavioral therapy that is delivered to subjects through the Internet. Swedish researchers from Uppsala University in Sweden investigated the efficacy of cognitive behavior therapy delivered over the internet for significantly reducing the distress caused by tinnitus (ringing in the ears).

Participants (n = 117) with tinnitus of more than 6 months duration were recruited through web pages and newspaper articles and randomly assigned to a CBT self-help manual in six modules or to a wait list control group (WLC). All contact with the subjects was conducted via the Internet with Web pages and E-mail correspondence.

After initial medical and psychological assessment subjects get access to the Internet treatment. Each week the subject chooses treatment components, reads information and instructions, plans the training and then practices during one week. He or she prints out registration sheets and reports the progress at the web site, receiving E-mail feedback from the therapist.

In the first randomized controlled phase of the study, 26 completed all stages of treatment (51% dropout), and 64 of the WLC group completed the evaluation measures. At 1-year follow-up, all participants had been offered the program and 96 provided outcome measures (18% dropout rate from baseline).

Tinnitus-related problems were assessed before and after treatment and at the 1-year follow-up. Daily diary ratings were included for 1 week before and 1 week following the treatment period.

The study showed that tinnitus-related distress, depression, and diary ratings of annoyance decreased significantly. Immediately following the randomized controlled phase (with a WLC), significantly more participants in the treatment group showed an improvement of at least 50% on the Tinnitus Reaction Questionnaire. At the uncontrolled follow-up, 27 (31%) of all participants had achieved a clinically significant improvement.

Researchers concluded that CBT via the Internet can help individuals decrease annoyance associated with tinnitus. They further suggest that high dropout rates or delay in completing treatment can be a characteristic of treatment via the Internet, but should be contrasted with the cost effectiveness and accessibility of this avenue.



Citation: Andersson G, Stromgren T, Strom L, Lyttkens L.Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus. Psychosom Med. 2002 Sep-Oct;64(5):810-6. [email protected] or [email protected]