Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial
BackgroundTinnitus is the perception of sound without an external auditive stimulus and can be a severe burden for affected patients. Medical guidelines recommend cognitive behavioral therapy (CBT) for tinnitus treatment, which effectively improves tinnitus-related distress a...
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JMIR Publications
2025-02-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e59575 |
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| author | Uso Walter Stefan Pennig Lothar Bleckmann Kristina Röschmann-Doose Thomas Wittig Jörn Thomsen Winfried Schlee |
| author_facet | Uso Walter Stefan Pennig Lothar Bleckmann Kristina Röschmann-Doose Thomas Wittig Jörn Thomsen Winfried Schlee |
| author_sort | Uso Walter |
| collection | DOAJ |
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BackgroundTinnitus is the perception of sound without an external auditive stimulus and can be a severe burden for affected patients. Medical guidelines recommend cognitive behavioral therapy (CBT) for tinnitus treatment, which effectively improves tinnitus-related distress and anxiety.
ObjectiveThis study investigates the outcome of a 9-month smartphone-based CBT for patients with tinnitus.
MethodsThe randomized controlled clinical trial in this study investigates the efficacy of a smartphone-based CBT for 187 patients with chronic tinnitus over a 9-month treatment period. In the initial 3 months, a waiting list design was applied, and in the subsequent study phase, the data of both treatment groups were collectively analyzed. The scores on the Tinnitus Questionnaire (TQ); 9-item Patient Health Questionnaire (PHQ-9); 9-item Self-Efficacy, Optimism, Pessimism (SWOP-K9) questionnaire; and 20-item Perceived Stress Questionnaire (PSQ-20) were assessed as endpoints after 3 and 9 months of treatment.
ResultsWe observed a statistically significant reduction in the tinnitus burden in patients who received the smartphone-based CBT intervention. Although no changes were observed initially in the TQ sum scores in the waiting control group (baseline mean, 37.8, SD 4.7; 3 months mean 37.5, SD 4.8; analysis of covariance [ANCOVA] P=.52), the scores significantly decreased once the app-based CBT had commenced. Data pooled from both groups revealed significant reduction in the TQ sum score by 12.49 (SD 1.44) (ANCOVA, P<.001) and 18.48 (SD 1.85) (ANCOVA, P<.001) points after 3 and 9 months, respectively, which was also clinically important. The calculated Cohen d was 1.38. Similarly, the scores on PSQ-20 (–9.14 points; ANCOVA, P<.001), PHQ-9 (–2.47 points; ANCOVA, P<.001), and SWOP-K9 (0.17 points; ANCOVA, P<.001) were significantly improved at the end of the therapy, with corresponding intermediate effect sizes after 9 months.
ConclusionsThe data in our study provide evidence of statistically significant, clinically relevant, and continuous benefits of an app-based CBT intervention in patients with chronic tinnitus.
Trial RegistrationDeutsches Register Klinischer Studien DRKS00022973; https://drks.de/search/de/trial/DRKS00022973 |
| format | Article |
| id | doaj-art-42ae408e7e07467a9a51587ed4212e13 |
| institution | DOAJ |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-42ae408e7e07467a9a51587ed4212e132025-08-20T02:43:54ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-02-0127e5957510.2196/59575Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled TrialUso Walterhttps://orcid.org/0009-0008-9411-950XStefan Pennighttps://orcid.org/0009-0006-5547-0781Lothar Bleckmannhttps://orcid.org/0009-0006-0916-5225Kristina Röschmann-Doosehttps://orcid.org/0000-0002-1375-2418Thomas Wittighttps://orcid.org/0009-0005-8092-2893Jörn Thomsenhttps://orcid.org/0000-0003-1601-9948Winfried Schleehttps://orcid.org/0000-0001-7942-1788 BackgroundTinnitus is the perception of sound without an external auditive stimulus and can be a severe burden for affected patients. Medical guidelines recommend cognitive behavioral therapy (CBT) for tinnitus treatment, which effectively improves tinnitus-related distress and anxiety. ObjectiveThis study investigates the outcome of a 9-month smartphone-based CBT for patients with tinnitus. MethodsThe randomized controlled clinical trial in this study investigates the efficacy of a smartphone-based CBT for 187 patients with chronic tinnitus over a 9-month treatment period. In the initial 3 months, a waiting list design was applied, and in the subsequent study phase, the data of both treatment groups were collectively analyzed. The scores on the Tinnitus Questionnaire (TQ); 9-item Patient Health Questionnaire (PHQ-9); 9-item Self-Efficacy, Optimism, Pessimism (SWOP-K9) questionnaire; and 20-item Perceived Stress Questionnaire (PSQ-20) were assessed as endpoints after 3 and 9 months of treatment. ResultsWe observed a statistically significant reduction in the tinnitus burden in patients who received the smartphone-based CBT intervention. Although no changes were observed initially in the TQ sum scores in the waiting control group (baseline mean, 37.8, SD 4.7; 3 months mean 37.5, SD 4.8; analysis of covariance [ANCOVA] P=.52), the scores significantly decreased once the app-based CBT had commenced. Data pooled from both groups revealed significant reduction in the TQ sum score by 12.49 (SD 1.44) (ANCOVA, P<.001) and 18.48 (SD 1.85) (ANCOVA, P<.001) points after 3 and 9 months, respectively, which was also clinically important. The calculated Cohen d was 1.38. Similarly, the scores on PSQ-20 (–9.14 points; ANCOVA, P<.001), PHQ-9 (–2.47 points; ANCOVA, P<.001), and SWOP-K9 (0.17 points; ANCOVA, P<.001) were significantly improved at the end of the therapy, with corresponding intermediate effect sizes after 9 months. ConclusionsThe data in our study provide evidence of statistically significant, clinically relevant, and continuous benefits of an app-based CBT intervention in patients with chronic tinnitus. Trial RegistrationDeutsches Register Klinischer Studien DRKS00022973; https://drks.de/search/de/trial/DRKS00022973https://www.jmir.org/2025/1/e59575 |
| spellingShingle | Uso Walter Stefan Pennig Lothar Bleckmann Kristina Röschmann-Doose Thomas Wittig Jörn Thomsen Winfried Schlee Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial Journal of Medical Internet Research |
| title | Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial |
| title_full | Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial |
| title_fullStr | Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial |
| title_full_unstemmed | Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial |
| title_short | Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial |
| title_sort | continuous improvement of chronic tinnitus through a 9 month smartphone based cognitive behavioral therapy randomized controlled trial |
| url | https://www.jmir.org/2025/1/e59575 |
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