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- Andersson, Gerhard, 1966-, et al.
(author)
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Hyperacusi - ett outforskat område. Kognitiv beteendeterapi kan lindra besvären vid ljudöverkänslighet, ett tillstånd med många frågetecken
- 2005
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 44, s. 3210-3212
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Journal article (peer-reviewed)abstract
- Hyperacusis innebär extrem känslighet för vardagens ljud är ett problem som drabbar cirka 8% av befolkningen. I svåra fall uppstår undvikande av många situationer samt en vana att skydda öronen med hörselskydd även i situationer där det inte behövs. Orsakerna till hyperacusis är till viss del kända, men många frågetecken kvarstår. För hyperacusis finns ingen dokumenterat botande behandling, men kognitiv beteendeterapi, samt eventuellt även tinnitus retraining therapy med brusgenerator, kan minska besvären,. Gott omhändertagande och en multidisciplinär utredning är att rekommendera i svåra fall. En av de viktigaste uppgifterna för framtida forskning är att kartlägga naturalförloppet vad gäller hyperacusis, då detta är i stort okänt. Det finns även ett stort behov av kontrollerade behandlingsstudier.
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| 2. |
- Andersson, Gerhard, 1966-, et al.
(author)
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Treatment of tinnitus in the elderly : A controlled trial of cognitive behavior therapy
- 2005
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In: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 44:11, s. 671-675
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Journal article (peer-reviewed)abstract
- The aim of the study was to investigate the effects of cognitive behavioral therapy (CBT) in elderly people with tinnitus (<65 years). Thirty-seven patients were called in for a structured interview. Following exclusion, twenty-three participated in the trial. All participants underwent medical ear, nose, and throat (ENT) examination, audiometry, and tinnitus matchings. A randomized controlled design with a waiting list control group was used. A CBT treatment package was delivered in six weekly two hour group sessions. Outcome was measured using validated self-report inventories and daily diary ratings of annoyance, loudness and sleep quality for one week pre-treatment, post-treatment. A three month follow-up was included at which time all participants had received treatment, but in a shorter format for the control group. Results showed statistically significant reductions of tinnitus-related distress. Thus, CBT was better than no treatment, but the particular aspects of CBT that contributed to the effects can not be established. In conclusion, the findings give some support for the use of group CBT for elderly people with tinnitus. © 2005 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.
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| 3. |
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| 4. |
- Kaldo-Sandström, Viktor, et al.
(author)
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Internet-based cognitive-behavioral self-help treatment of tinnitus : Clinical effectiveness and predictors of outcome
- 2004
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In: American Journal of Audiology. - : American Speech Language Hearing Association. - 1059-0889 .- 1558-9137. ; 13:2, s. 185-192
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Journal article (peer-reviewed)abstract
- The aim of this investigation was to evaluate Internet-based cognitive-behavioral therapy for tinnitus in a nonrandomized clinical effectiveness study with a sample of consecutive patients referred for psychological treatment (N = 77). Results were calculated at a group level on an intention-to-treat basis and showed significant reductions of distress on the Tinnitus Reaction Questionnaire (P. H. Wilson, J. Henry, M. Bowen, & G. Haralambous, 1991), the Hospital Anxiety and Depression Scale (A. S. Zigmond & R. P. Snaith, 1983), and on the Insomnia Severity Index (C. H. Bastien, A. Vallières, & C. M. Morin, 2001). A 3-month follow-up showed that patients remained improved. The dropout rate was 30%. Treatment compliance, external referral to the treatment, and number of earlier treatments for tinnitus were associated with positive outcome. The number of e-mails between therapist and patient concerning treatment problems was associated with worse outcome. Internet-based cognitive-behavioral therapy holds some promise as a treatment modality for tinnitus. Future research should focus on further controlled evaluations of the treatment technique and evaluate the cost-effectiveness compared to other forms of tinnitus treatments. © American Speech-Language-Hearing Association.
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| 5. |
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| 6. |
- Kaldo, Viktor, et al.
(author)
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Internet-Based Cognitive Behaviour Therapy for Tinnitus Patients Delivered in a Regular Clinical Setting: Outcome and Analysis of Treatment Dropout
- 2013
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In: Cognitive Behaviour Therapy. - : Taylor and Francis (Routledge): STM, Behavioural Science and Public Health Titles / Taylor and Francis (Routledge). - 1650-6073 .- 1651-2316. ; 42:2, s. 146-158
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Journal article (peer-reviewed)abstract
- Cognitive behaviour therapy (CBT) can reduce tinnitus distress but is not available for most patients. Therapist guided, internet-based CBT (ICBT) increase availability and has been shown to be effective. However, the initial positive results need to be replicated in larger samples, and treatment dropout has not been thoroughly studied. Moreover, it has not been evaluated if a low-intensity version of ICBT without therapist contact could be an alternative for patients who do not need or are able to manage the full ICBT-program. This study evaluated two parallel interventions delivered in regular care: ICBT for tinnitus distress (n=293) and a low-intensity version of ICBT (n=81) for patients with lower levels of tinnitus distress. We also explored predictors of dropout from ICBT and if dropout influences outcome. Tinnitus Reaction Questionnaire (Wilson, Henry, Bowen, andamp; Haralambous, 1991) was used as the primary outcome. Secondary outcomes were measures of depression, anxiety, sleep, and sound sensitivity. Significant reductions following ICBT were found on all measures after treatment and also at a three-month follow-up. Patients receiving low-intensity ICBT showed a significant reduction in distress, even when they had low levels of distress initially. Treatment dropout was preceded by an increase in days spent at each treatment step but not by an increased distress. Early dropout was related to worse outcome. ICBT can be used in a regular clinical setting to reduce tinnitus distress. Early dropouts may need additional management. For help-seeking patients with lower distress, a low-intensity version of ICBT can be used.
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| 7. |
- Kaldo, Viktor, et al.
(author)
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Internet versus group cognitive-behavioral treatment of distress associated with tinnitus : A randomized controlled trial
- 2008
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In: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888. ; 39:4, s. 348-359
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Journal article (peer-reviewed)abstract
- Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT), and the treatment can be delivered in different ways. The most recent format is Internet-based self-help. The aim of this study was to compare this treatment (n = 26) with standard group-based CBT (n = 25) in a randomized controlled trial. Outcomes on self-report inventories measuring tinnitus distress were evaluated immediately after and 1 year after treatment. Results showed that both groups had improved, and there were few differences between them. The effect size for the Internet treatment was d = 0.73 (95% CI = 0.16-1.30) and for the group treatment was d = 0.64 (95% CI = 0.07-1.21). The Internet treatment consumed less therapist time and was 1.7 times as cost-effective as the group treatment. At pretreatment patients rated the Internet treatment as less credible than the group treatment. In conclusion, Internet treatment for tinnitus distress merits further investigation, as the outcomes achieved are promising.
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| 8. |
- Kaldo, Viktor, et al.
(author)
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Internetbaserad självhjälpsbehandling mot tinnitusbesvär
- 2004
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In: Svenska läkartidningen. - 0371-439X. ; 101, s. 556--560
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Journal article (peer-reviewed)abstract
- Tinnitusbesvär kan minskas med kognitiv beteendeterapi. Självhjälpsbehandling, ofta med viss terapeutkontakt, kan öka tillgången på denna terapiform. Medicinskt färdigutredda patienter vid audiologiska avdelningen på Akademiska sjukhuset i Uppsala har sedan 1999 kunnat genomgå kognitiv beteendeterapi mot tinnitusbesvär i grupp, individuellt eller som Internetbaserad självhjälpsbehandling. Självhjälpsbehandlingen utgår från en webbplats och består av s k verktyg. En träningsvecka omfattar val av verktyg, information, instruktioner, planering av verktygens användning samt träning som registreras. Terapeuten följer patientens behandling och ger återkoppling via e-post. Stor vikt läggs vid att hålla kontinuerlig kontakt med patienten under behandlingen.Internetbehandlingens effekt har prövats i en kontrollerad studie, i en klinisk replikation samt i en direkt jämförelse med vanlig kognitiv beteendeterapi i gruppform. Resultaten har varit goda och jämförbara med ordinarie behandling.
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| 9. |
- Kaldo, Viktor, et al.
(author)
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Use of a self-help book with weekly therapist contact to reduce tinnitus distress : a randomized controlled trial
- 2007
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In: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 63:2, s. 195-202
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Journal article (peer-reviewed)abstract
- Objective: Tinnitus distress can be reduced by means of cognitive-behavior therapy (CBT). To compensate for the shortage of CBT therapists, we aimed, in this study, to investigate the effects of a CBT-based self-help book guided by brief telephone support. Methods: Seventy-two patients were randomized either to a self-help book and seven weekly phone calls or to a wait-list control condition, later on receiving the self-help book with less therapist support. The dropout rate was 7%. Follow-up data 1 year after completion of treatment were also collected (12% dropout). The Tinnitus Reaction Questionnaire (TRQ) was the main outcome measure, complemented with daily ratings of tinnitus and measures of insomnia, anxiety, and depression. Results: On the TRQ, significant reductions were found in the treatment group both immediately following treatment and at 1-year follow-up. In the treatment group, 32% reached the criteria for clinical significance (at least 50% reduction of the TRQ) compared to 5% in the wait-list group. Directly after treatment, two out of five measures showed significant differences in favor of the treatment with more therapist support compared with the group who, after their waiting period, received little therapist support. The self-help treatment was estimated to be 2.6 (seven phone calls) and 4.8 (one phone call) times as cost-effective as regular CBT group treatment. Conclusions: Guided self-help can serve as an alternative way to administer CBT for tinnitus. Preliminary results cast some doubts on the importance of weekly therapist contact. The effect size was somewhat smaller than for regular CBT, but on the other hand, the self-help seems far more cost-effective. Future studies should compare treatment modalities directly and explore cost-effectiveness more thoroughly.
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