{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:41:52Z","timestamp":1791830512332,"version":"4.3.4"},"reference-count":45,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n Tinnitus 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study investigates the outcome of a 9-month smartphone-based CBT for patients with tinnitus.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We 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 (\u20139.14 points; ANCOVA, P<.001), PHQ-9 (\u20132.47 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.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The 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.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Deutsches Register Klinischer Studien DRKS00022973; https:\/\/drks.de\/search\/de\/trial\/DRKS00022973<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/59575","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T12:38:11Z","timestamp":1734957491000},"page":"e59575","source":"Crossref","is-referenced-by-count":13,"title":["Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9411-950X","authenticated-orcid":false,"given":"Uso","family":"Walter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5547-0781","authenticated-orcid":false,"given":"Stefan","family":"Pennig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0916-5225","authenticated-orcid":false,"given":"Lothar","family":"Bleckmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1375-2418","authenticated-orcid":false,"given":"Kristina","family":"R\u00f6schmann-Doose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8092-2893","authenticated-orcid":false,"given":"Thomas","family":"Wittig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-9948","authenticated-orcid":false,"given":"J\u00f6rn","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7942-1788","authenticated-orcid":false,"given":"Winfried","family":"Schlee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.2189"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s10162-022-00874-y"},{"key":"ref3","unstructured":"Pastorkov\u00e1NHol\u00fdRProch\u00e1zkov\u00e1Ket alProblematika roztrou en\u00e9 skler\u00f3zy v otoneurologick\u00e9 ambulanci, mezioborov\u00e1 spolupr\u00e1ce otoneurologa a neurologaOtorhinolaryngology & Phoniatrics20212025-01-30https:\/\/tinyurl.com\/3ajdh3v2"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pharmtox-010818-021556"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10132896"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abb2830"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2024.101438"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093087"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1177\/01455613221139211"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-019-0633-7"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2021.01459"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-018-0654-4"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012614.pub2"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072754"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-200209000-00014"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2196\/39076"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2196\/27584"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000337"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.08.001"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000258202"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1026\/0012-1924.50.4.171"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000151491.80178.78"},{"issue":"8","key":"ref23","first-page":"275","volume":"49","author":"Scholler, G","year":"1999","journal-title":"Psychother Psychosom Med Psychol"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-10-79"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2018.1442591"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-022-02072-z"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12227117"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.04.002"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291720003700"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1044\/2015_aja-14-0080"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000174174.38908.c6"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0000000000000310"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2010.12.006"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.671"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1097\/01.aud.0000240504.77861.1a"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-003-0930-y"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1682\/jrrd.2006.02.0018"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6882-12-235"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.4324\/9780203771587"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1097\/mao.0000000000004139"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.969800"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.2196\/20283"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.03093"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12031169"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0034583"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e59575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:53:31Z","timestamp":1785851611000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e59575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,18]]},"references-count":45,"URL":"https:\/\/doi.org\/10.2196\/59575","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.59575","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,18]]}}}