Effectiveness of a cognitive behavioural therapy on patients with chronic rhinosinusitis with nasal polyps: a randomised controlled trial.

OBJECTIVE

Chronic rhinosinusitis with nasal polyps patients awaiting functional endoscopic sinus surgery have unmet psychological needs. This study evaluated cognitive behavioural therapy's efficacy in relieving their anxiety, depression and sinus symptoms.

METHODS

A single-centred randomised controlled trial enrolled 144 patients (51 females, 93 males), randomising 72 to six weeks of cognitive behavioural therapy (cognitive restructuring, behavioural activation) and 72 to routine pre-operative education. Outcomes were assessed via Self-rating Anxiety Scale, Self-rating Depression Scale and Sino-Nasal Outcome Test at pre-intervention and 1, 3, 6 and 12 months post-functional endoscopic sinus surgery.

RESULTS

Compared with the control group, the cognitive behavioural therapy group had significantly lower scores at all post-functional endoscopic sinus surgery time points (all p < 0.001), with benefits sustained for one year. Efficacy was consistent across most subgroups (ages and disease duration), except the 61- to 70-year-old cognitive behavioural therapy subgroup with late-phase score increases (still lower than controls).

CONCLUSION

Six weeks of structured cognitive behavioural therapy improves chronic rhinosinusitis with nasal polyps patients' pre-operative mental health and sinus symptoms and should be core to their multimodal pre-rehabilitation.