Abstract Introduction: Subjective tinnitus is identified as a hallucinatory perception occurring in individuals. Our aim was to explore the underlying mechanisms of cognitive behavioural therapy in the treatment of tinnitus. Material and methods: We performed a meta-analysis of observational studies identified from 4 databases to evaluate the associations of cognitive behaviorial therapy and subjective tinnitus from 1990 to 2023. We conducted MR analyses to strengthen the causal inference in these associations. Independent single-nucleotide polymorphisms without linkage disequilibrium (r2 < 0.001) that were strongly associated (P < 5 × 10 ^-8) with anxiety and depressive states on GWAS. Data on Tinnitus were obtained from a GWAS data for tinnitus was acquired from FinnGen research. Results: Mendelian randomization showed that there was a clear causal relationship between anxiety and depression and tinnitus. The results of the meta-analysis suggest that cognitive behavioral therapy has a positive effect on improving the psychoacoustic symptoms of tinnitus. Conclusion: Cognitive-behavioral therapy can have a positive impact on the psychoacoustic level of tinnitus by improving the patient’s anxiety and depression state.