scholarly journals Effectiveness of a Multicomponent Group Psychological Intervention Program in Patients with Inflammatory Bowel Disease: A Randomized Trial

Author(s):  
Purificación Bernabeu ◽  
Carlos van-der van-der Hofstadt ◽  
Jesús Rodríguez-Marín ◽  
Ana Gutierrez ◽  
Miguel Raúl Alonso ◽  
...  

(1) Background: Stress, anxiety, and depression have been identified as factors that influence the development of inflammatory bowel disease (IBD). The main aim of this study was to test the effectiveness of group multicomponent cognitive-behavioral therapy at reducing stress, anxiety, and depression, and improving quality of life and the clinical course of the disease. (2) Methods: A total of 120 patients were evaluated using the General Perceived Stress Scale, Scale of Stress Perceived by the Disease, the anxiety and depression scale, and quality of life questionnaire for patients with IBD. Disease activity was measured using the Mayo Index for ulcerative colitis and CDAI for Crohn's disease, as well as the number of relapses self-reported by patients. Patients were randomized to receive group multicomponent cognitive-behavioral therapy or treatment as usual. (3) Results: The psychological intervention reduced stress (EAE: 45.7 ± 8.8 vs. 40.6 ± 8.4, p = 0.0001; PSS: 28.0 ± 7.3 vs. 25.1 ± 5.9, p = 0.001) and improved quality of life (164.2 ± 34.3 vs. 176.2 ± 28.0, p = 0.001). An improvement was found in the number of relapses self-reported by patients (0.2 relapses/patient vs. control 0.7 relapses/patient; p = 0.027). No differences were found in disease activity indexes. (4) Conclusions: Psychological therapy was associated with improved stress, quality of life and with a decrease in the number of relapses self-reported by patients. Clinical trial registration number: NCT02614014

2019 ◽  
Vol 48 (1) ◽  
pp. 91-102 ◽  
Author(s):  
Floor Bennebroek Evertsz’ ◽  
Mirjam A.G. Sprangers ◽  
Laura M. de Vries ◽  
Robbert Sanderman ◽  
Pieter C.F. Stokkers ◽  
...  

AbstractBackground:According to cognitive behavioural theory, cognitive factors (i.e. underlying general dysfunctional beliefs and (situation) specific illness beliefs) are theorized to lead to outcomes like anxiety and depression. In clinical practice, general dysfunctional beliefs are generally not tackled directly in short-term-therapy.Aims:The goal of the present study was to investigate the associations of general versus specific illness beliefs on anxiety and depressive symptoms and psychiatric disorders among a subgroup of patients with inflammatory bowel disease (IBD) with poor mental quality of life (QoL).Method:This study concerns cross-sectional data, collected at baseline from a randomized clinical trial. One hundred and eighteen patients, recruited at four Dutch hospitals, with poor QoL (score ≤23 on the mental health subscale of the Short-Form 36-item Health-Survey; SF-36) were included. General dysfunctional beliefs were measured by the Dysfunctional Attitude Scale (DAS), specific illness beliefs by the Illness Perceptions Questionnaire-Revised (IPQ-R), anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS), and psychiatric disorders by the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I).Results:Univariate analyses showed associations between the level of anxiety and/or depression and general dysfunctional beliefs and four specific illness beliefs (consequences, personal control, emotional representations and treatment control). Among patients with IBD with psychiatric disorders, only the DAS was significantly associated with anxiety and depression (DAS added to IPQ-R and IPQ-R added to DAS).Conclusions:Psychological interventions may have to target general dysfunctional beliefs of patients with IBD with co-morbid psychiatric disorders to be effective. These patients with IBD are especially in need of psychological treatment.


2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S661-S661
Author(s):  
L Sweeney ◽  
R Moss-Morris ◽  
W Czuber-Dochan ◽  
C Norton

Abstract Background Chronic pain is a poorly managed symptom of inflammatory bowel disease (IBD). Cognitive behavioural therapy (CBT) has an evidence-base in functional gastrointestinal conditions and chronic pain. We aimed to test the feasibility and acceptability of a 9-week online facilitator-supported CBT intervention, tailored for people with chronic IBD-related pain. Methods A single arm pre-post design with nested qualitative interviews was used with 20 individuals with IBD and chronic pain. Participants were recruited online through an IBD charity and had consented to research in a previous survey or responded to an online charity advert. Individuals who met the inclusion criteria e.g. reported a pain-interference score of ≥4/10 (Brief Pain Inventory) and had no indicators of acute causes of pain, were invited to take part. Faecal calprotectin was collected. Outcomes included recruitment and retention rates, pain interference and severity (Brief Pain Inventory), quality of life, psychosocial measures and self-reported disease activity (IBD-Control). Follow-up face to face or telephone interviews were conducted following the intervention to obtain feedback on sessions and tasks, facilitator support and areas for improvement. Results Of 145 survey respondents contacted, 55 (37.9%) responded. Two additional individuals were recruited from the study advertisement. 20/57 (35.1%) met screening and eligibility criteria. Twenty consented to the study and 60% of those returning a stool sample were in clinical remission (<250ug/g). One individual withdrew after Session 1, 17 (85%) engaged with intervention sessions and 11 (55%) completed at least 5/9 sessions. 16 (80%) of recruited participants completed the post-intervention questionnaire at week 9. Mean score for overall acceptability was 43.4 (0–70). No changes were observed for pain outcomes, but quality of life and pain self-efficacy increased following the intervention. Self-reported disease activity, depression, anxiety, pain catastrophising and avoidance resting behaviour decreased. Qualitative feedback demonstrated the value of particular elements of the intervention, such as thought monitoring and facilitator support. Some participants felt content was oversimplified and that further information was needed on practical management strategies, including diet. Conclusion Online CBT for chronic IBD-related pain appears feasible and acceptable. The results demonstrate positive effects for improving quality of life and reducing psychological distress, however online and face to face recruitment methods are recommended. To establish efficacy for reducing pain and improving quality of life, larger randomised controlled trials are required.


2019 ◽  
Vol 25 (12) ◽  
pp. 1945-1956 ◽  
Author(s):  
Gertrude van den Brink ◽  
Luuk Stapersma ◽  
Anna Sophia Bom ◽  
Dimitris Rizopolous ◽  
C Janneke van der Woude ◽  
...  

Abstract Background Anxiety and depressive symptoms are prevalent in patients with inflammatory bowel disease (IBD) and may negatively influence disease course. Disease activity could be affected positively by treatment of psychological symptoms. We investigated the effect of cognitive behavioral therapy (CBT) on clinical disease course in 10–25-year-old IBD patients experiencing subclinical anxiety and/or depression. Methods In this multicenter parallel group randomized controlled trial, IBD patients were randomized to disease-specific CBT in addition to standard medical care (CBT + care us usual [CAU]) or CAU only. The primary outcome was time to first relapse in the first 12 months. Secondary outcomes were clinical disease activity, fecal calprotectin, and C-reactive protein (CRP). Survival analyses and linear mixed models were performed to compare groups. Results Seventy patients were randomized (CBT+CAU = 37, CAU = 33), with a mean age of 18.3 years (±50% < 18 y, 31.4% male, 51.4% Crohn’s disease, 93% in remission). Time to first relapse did not differ between patients in the CBT+CAU group vs the CAU group (n = 65, P = 0.915). Furthermore, clinical disease activity, fecal calprotectin, and CRP did not significantly change over time between/within both groups. Exploratory analyses in 10–18-year-old patients showed a 9% increase per month of fecal calprotectin and a 7% increase per month of serum CRP in the CAU group, which was not seen in the CAU+CBT group. Conclusions CBT did not influence time to relapse in young IBD patients with subclinical anxiety and/or depression. However, exploratory analyses may suggest a beneficial effect of CBT on inflammatory markers in children.


2013 ◽  
Vol 19 ◽  
pp. S48
Author(s):  
Francisca Dias de Castro ◽  
Joana Magalhães ◽  
Pedro Carvalho ◽  
Maria João Moreira ◽  
Paula Mota ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document