The article (1) unfortunately omits any mention of self-help. The charitable self-help organization Deutsche Tinnitus Liga (DTL, the German tinnitus association) makes a valuable contribution to support affected persons in this context (2). However, the authors deserve credit for explaining the topic of tinnitus so comprehensively. At the same time it should be clear that we are mostly talking about management, not cure. For patients with severe tinnitus, even just reducing the burden is a realistic therapeutic objective.
Scientific evaluations have shown that of the 14 000 DTL members, 16% have grade 4 tinnitus (mini tinnitus questionnaire–12, Mini-TF12) (3). In order to confirm the effectiveness of self-help in qualified self-help groups, the DTL has started a large, prospective 3-year study in collaboration with the University Medical Center Hamburg-Eppendorf (2, 4).
In our experience there are better grading scales for the severity of tinnitus than the external assessment that the authors list in the Box. The DTL on its home page provides a tinnitus test for interested parties that is based on the scientifically evaluated mini-tinnitus questionnaire 12 and is being undertaken by some 20 000 affected persons every year. 16% of these are most severely affected (3).
The article mentions “tinnitus patients” in several places, sometimes for all those affected, but elsewhere for those who are actually suffering, which may well be termed “patients.” If suffering caused by tinnitus is the main symptom then tinnitus should not be subsumed under the symptom category H 93.1 in the ICD-10 but should be integrated as a disease under a new category that is yet to be established. The DTL—supported by the Association of the Scientific Medical Societies in Germany (AWMF)—has taken this up with the German Institute of Medical Documentation and Information (Deutsches Institut für Medizinische Dokumentation und Information, DIMDI) for the purposes of the ICD-10-GM 2014.
Deutsche Tinnitus-Liga e. V., Wuppertal
Conflict of interest statement
Mr Albert is the honorary chair of the Deutsche Tinnitus Liga e.V. (the German Tinnitus Association, reg assoc).
Mr Bergmann is the managing director of the Deutsche Tinnitus Liga e.V. (the German Tinnitus Association,reg assoc).
|1.||Kreuzer PM, Vielsmeier V, Langguth B: Chronic tinnitus: an interdisciplinary challenge. Dtsch Arztebl Int 2013; 110(16): 278–84 VOLLTEXT|
|2.||Goebel G: Was ist Tinnitus-Selbsthilfe und welche Bedeutung hat sie? In: Hesse G (ed.): Tinnitus. Stuttgart: Thieme 2008: 175–77.|
|3.||Goebel G: Psychische Komorbidität bei Tinnitus. Psychiatr Psychother Up2date 2010; 4: 389–408 CrossRef|
|4.||Kofahl C, Wagner S, Goebel, G: Evaluation der Wirksamkeit von Selbsthilfegruppenarbeit in der Deutschen Tinnitus-Liga e. V. (DTL). Tinnitus-Forum 2012; 3: 26–7.|