Tinnitus, the perception of a noxious, disabling internal sound without an external source, affects as many as 21% of adults, but best practices regarding treatment haven't been defined, and current treatments are fragmented and can be prolonged and costly. The two main treatment approaches used are tinnitus-retraining therapy, which focuses on sound habituation, and cognitive behavioral therapy, which focuses on dysfunctional beliefs about tinnitus and associated safety behaviors. Cima and colleagues developed a multidisciplinary protocol combining elements of tinnitus-retraining therapy with stepped cognitive behavior therapy (specialized care). A total of 492 adults were randomized to specialized care or usual care. Within each group, patients were stratified by tinnitus severity and hearing ability.

Over the 12-month follow-up, results were consistently better in the 245 patients who received specialized care, compared with the 247 patients assigned to usual care. Specialized-care patients had better health-related quality-of-life scores, less-severe tinnitus severity, and less impairment. In addition, specialized-care patients had less negative affect and tinnitus-related catastrophizing and fear. Patients with both mild and more-severe tinnitus benefited from specialized care, and no adverse effects were observed.-KR

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