Objective: To investigate the long-term outcome of patients with tinnitus, the long-term effects of cognitive behavioral therapy, and what properties of tinnitus predict distress at follow-up. Design: A longitudinal follow-up of a consecutive sample of patients with tinnitus initially seen by a clinical psychologist. Setting: Department of Audiology, University Hospital, Uppsala, Sweden. Participants: A consecutive series of 189 patients with tinnitus treated between January 1988 and March 1995 were sent a postal questionnaire booklet. One hundred forty-six (77 women and 69 men) provided usable responses, in all yielding a 77% response rate. Main Outcome Measures: A questionnaire was derived from a structured interview "Questions About Your Tinnitus." Also included were the Tinnitus Reaction Questionnaire and tinnitus-matching data. Results: Questionnaire data showed that many patients with tinnitus still experienced distress an average of 4.9 years after admission. Tolerance of tinnitus increased over time overall. For patients who had received cognitive behavioral therapy (59%), there was a reduction in tinnitus-related distress. Further, an open-ended question showed that the benefits from treatment outnumbered the deficits. Multiple regression analysis showed that tinnitus maskability at admission was a significant predictor of distress at follow-up. Conclusions: Severe tinnitus shows some signs of improvement over time, especially when psychological treatment has been given. Tinnitus maskability is an important prognostic factor of future tinnitus annoyance.
