Web therapy may help tinnitus sufferers cope with problem

Internet-based therapy can help sufferers cope with tinnitus, the medical term for the ringing sound in the ears that is experienced by 10 to 14 percent of adults, suggest the results of a Swedish study.

No cure for tinnitus exists, although some experts recommend the use of hearing aids and white-noise generators to help minimize the ringing, and sometimes hissing, chirping or clicking sounds associated with tinnitus. Symptoms are mild for most tinnitus patients, but the one-third of patients with more serious symptoms are also prone to depression, anxiety and insomnia, and can have difficulty participating in everyday activities.

Previous studies have found face-to-face cognitive behavior therapy – which helps patients unlearn undesirable reactions through awareness, goal-setting and homework assignments – can help with tinnitus. “Psychological treatment for tinnitus is not aimed at eliminating the tinnitus; rather, reduced annoyance is the goal,” says lead study author Gerhard Andersson, Ph.D., from the Departments of Audiology and Psychology at the University Hospital in Uppsala, Sweden. This is the first Internet-based study on tinnitus.

Andersson and colleagues recruited nearly 120 tinnitus patients, age 18-70, through newspaper articles as well as the Swedish Hard of Hearing Association’s Web site. Half of the participants received treatment immediately, while the other half who received delayed treatment served as the control group.

Participants received six weeks of cognitive behavioral exercises, which included relaxation, breathing and sleep management training via the Internet. They were required to submit homework assignments and weekly reports on a Web page and were encouraged to e-mail the researchers with their questions and concerns.

Study participants who received the Web therapy reduced their tinnitus-related symptoms – including distress, depression, annoyance and anxiety – to a greater extent than the control group, the researchers found. However the results were not dramatic: less than a third of those receiving Internet treatment reported achieving substantial improvement of their symptoms. But even without substantial improvement, “our impression from e-mails is that a majority of completers found the treatment to be beneficial,” Andersson says. The study results appear in the September/October issue of the journal Psychosomatic Medicine.

Andersson and colleagues note several caveats concerning Internet studies. A high percentage of participants dropped out at the beginning of the study, which suggests that people who are quick to send an e-mail response to a study advertisement may be just as quick to drop out when confronted with a demanding treatment regimen.

Also, they say, Internet study patients should be monitored closely via telephone contact, and the treatment manual should be structured to include e-mail interactions between patient and therapy at every treatment step, suggest the researchers, who add that future studies should also compare face-to-face with Internet treatment.

The researchers regard the Internet as a complement, rather than an alternative, to face-to-face treatment. But since it’s cost effective and convenient for those who are far from treatment centers and it can be modified and individualized, unlike self-help books, the Internet shows great promise as a tinnitus treatment tool, according to the study. The treatment is available as a regular service at the hospital.

“Most likely, the Internet will change the way health care is provided in the future, and hence there is an urgent need to evaluate the pros and cons of Internet-administrated treatment,” Andersson concludes.

This research was supported through grants from the Swedish Council for Social Research and the Swedish Hard of Hearing Association.

FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Gerhard Andersson at gerhard.andersson@psyk.uu.se, or +46 18-4712116.
Psychosomatic Medicine: Contact Victoria White at (352) 376-1611, ext. 5300, or visit www.psychosomaticmedicine.org.

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