Chronischer Tinnitus

Zusammenfassung

Eine Geräuschwahrnehmung ohne externen akustischen Stimulus wird als Tinnitus bezeichnet. Besonders durch Begleiterkrankungen des affektiven Spektrums kann chronischer Tinnitus zur Reduktion der Lebensqualität führen. Es existiert derzeit kein “Königsweg” bei der Behandlung von Tinnitus, jedoch sollte dies keinen Anlass zur Hilflosigkeit auf Seiten des Therapeuten darstellen. Vielmehr sind allgemeine therapeutische Optionen verfügbar, welche sich mit geringem Aufwand in die tägliche Praxis integrieren lassen. Behandlungsansätze erstrecken sich vom beratenden therapeutischen Gespräch über kognitive Verhaltenstherapie, Neurofeedback-Methoden und neuromodulatorischen Techniken bis hin zur pharmakologischen Behandlung, die besonders bei tinnitusassoziierten Symptomen wie Schlafund Konzentrationsstörungen indiziert sein kann. Aufgrund der zunehmenden Evidenz für die Beteiligung zentralnervöser Strukturen an der Pathogenese von chronischem Tinnitus sowie der hohen Komorbidität mit genuin psychiatrischen Krankheitsbildern, wie Depression und Angsterkrankungen, bestehen gute Gründe für Nervenärzte, sich eingehender mit Tinnitus zu beschäftigen.

Summary

Tinnitus is the perception of sound in absence of any external acoustic stimuli. It may lead to significant reductions of quality of life especially by affective comorbidities. Tinnitus is difficult to treat but this should not lead to feelings of helplessness in therapists. In contrary, there is a multitude of general treatment options at hand which can be integrated in daily therapeutic routine quite easily. General treatment options for chronic tinnitus range from counseling, cognitive behavioral therapy, neurofeedback and neuromodulatory techniques to pharmacological treatment, which may especially be suitable in targeting tinnitus-associated symptoms like sleeping disorders and attentional deficits. Awareness of psychiatrists and neurologist about tinnitus is considered to be vital both because of the growing evidence for a decisive role of the central nervous system in the pathophysiology of chronic tinnitus and its comorbid associations with neuropsychiatric core symptoms like depressive disorders and anxiety.

Schlüsselwörter

Chronischer Tinnitus - affektive Erkrankungen - Depression - Angsterkrankungen

Keywords

Chronic tinnitus - affective disorders - depression - anxiety

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