A Meta-Analysis on Efficacy of Cognitive Behavioral Therapy for Tinnitus

CAI Wei; LI Peishan; DAI Tianrong; XIE Hui

doi:10.3969/j.issn.1672-2922.2023.06.009

Abstract：Objective To systematically investigate the efficacy of Cognitive Behavioral Therapy(CBT)for tinni-tus.Methods The China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP,CBM,PubMed,Cochrane Library,Web of Science and Embase were searched for randomized controlled trials(RCTs)or cohort studies involving CBT for tinnitus published from database inception to 2022.Studies meeting the inclusion and exclusion criteria were screened and analyzed with the RevMan 5.4 software.Result A total of 11 RCTs were selected,including a double-cen-ter study involving 12 study items and 1,158 patients(586 in the CBT treatment group and 572 in the control[other ther-apies or waiting list]group).The rate of effectiveness with CBT was better than control in 4 included papers(P＜0.05),with primary indicators including the Tinnitus Handicap Index(THI),Tinnitus Reaction Questionnaire(TRQ)and Tinni-tus Functional Index(TFI)(but not Tinnitus Questionnaire)scores)all better in the treatment group than in the control group(P＜0.05).Secondary indicators including the Insomnia Severity Index(ISI),Hospital Anxiety and Depression Scale-Anxiety(HADS-A)and Hospital Anxiety and Depression Scale-Depression(HADS-D)scores were also better in the treatment group(P＜0.05).Further analysis based on THI scores showed that treatment duration and control group setting were possible contributing factors to outcome heterogeneity.Outcomes difference between treatment and control groups became significant when treatment course was longer than 3 months(P＜0.05).Although control setting did not influence CBT superiority,including non-waiting list subjects in the control group contributed to increased heterogene-ity.Conclusion Compared with conventional treatments or waiting list,CBT yields better treatment outcomes in tinni-tus.