Long-term effects of the "Heidelberg Model of Music Therapy" in patients with chronic tinnitus

Abstract

Objective: The "Heidelberg Model of Music Therapy for Chronic Tinnitus" is a manualized short term treatment (nine 50-minutes sessions of individualized therapy on five consecutive days). It has proven to be efficient in reducing tinnitus symptoms in the short run. Now the long-term impact of the treatment after up to 5.4 years should be explored.

Materials and methods: 206 patients who had attended the neuro-music therapy were addressed in a structured follow-up questionnaire survey. 107 complete questionnaires entered analysis. Follow-up time was 2.65 (SD 1.1) years.

Results: 76% of the patients achieved a reliable reduction in their tinnitus scores, the overall tinnitus distress as measured by the Mini-TQ diminished from 11.9 (SD = 4.9) to 7.4 (SD = 5.2) points, 87% of the patients were satisfied by the way they were treated during therapy, and 71% of the patients did not undergo any further treatment after. Evaluation of therapeutic elements displays, that only music therapy specific interventions were rated helpful by the patients. Tinnitus related factors (such as tinnitus pitch or loudness, time since onset) did not influence therapy outcome but female gender, positive therapeutic relationship, and higher initial Mini-TQ scores became apparent as factors predicting better chances for greater therapy success.

Discussion: The "Heidelberg Model of Music Therapy for Chronic Tinnitus" seems to be effective in the long run. The outcome effect size of d' = 0.89, can be accounted for as "large" effect and falls into the upper range value compared to established treatments.

Keywords: Music Therapy; logistic regression; long-term outcome; odds ratio; tinnitus; tinnitus questionnaire.

Figures

Figure 1

Jacobson-Plot of TQ-Scores. The graph depicts individual TQ-scores of each patient at admission and follow-up. All data outside the area between the two diagonal lines in the middle belong to patients with reliable changes, i.e. changes succeed 1.8 points. Scores above the line indicate a reliable deterioration, scores below the lines indicate a reliable bettering, and scores between the lines indicate no reliable change.

Figure 3

Scatter plot therapy outcome versus elapsed time. Correlation of therapy outcome (change in absolute Mini-TQ scores) versus elapsed time (years since end of therapy).

Figure 2

clinical categories of patients according to the Mini-TQ severity grades. Distribution of the patients in the four clinical categories of the Mini-TQ at the different times of data collection.