scholarly journals Psychological treatment for irritable bowel syndrome

Author(s):  
Katleen Bogaerts ◽  
Lukas Van Oudenhove
2005 ◽  
Vol 39 (9) ◽  
pp. 807-815 ◽  
Author(s):  
Francis Creed ◽  
Elspeth Guthrie ◽  
Joy Ratcliffe ◽  
Lakshmi Fernandes ◽  
Christine Rigby ◽  
...  

Objective: We have previously reported improved health-related quality of life in patients with severe irritable bowel syndrome (IBS) following psychological treatments. In this paper, we examine whether this improvement was associated with improvement in psychological symptoms and was confined to those patients who had concurrent psychiatric disorder. Method: Two hundred and fifty-seven patients with severe IBS entering a psychological treatment trial were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. At entry to the trial and 15 months later, patients were also assessed using the Hamilton Depression Rating Scale, Symptom Cheecklist-90 (SCL-90) and Short Form-36 (SF36) physical component summary score as the main outcome measure. Partial correlation was used to compare changes in SF36 score and changes in psychological scores while controlling for possible confounders, treatment group and baseline scores. Multiple regression analysis was used to examine whether changes in psychological scores, changes in pain and a history of abuse could account for most of the variance of change in SF36 physical component score. Results: Of 257 patients with severe IBS, 107 (42%) had a depressive, panic or generalized anxiety disorder at trial entry. There were moderate but significant correlations (0.21–0.47) between change in the psychological scores and the change in SF36 physical component scores. The correlation coefficients were similar in the groups with and without psychiatric disorder. The superiority of psychotherapy and antidepressant groups over treatment as usual was similar in those with and without psychiatric disorder. Multiple regression found significant independent effects of change in depression, anxiety, somatization and abdominal pain but there was still variance explained by treatment group. Conclusions: In severe IBS improvement in health-related quality of life following psychotherapy or antidepressants is correlated with, but not explained fully by reduction of psychological scores. A more complete understanding of how these treatments help patients with medically unexplained symptoms will enable us to refine them further.


2000 ◽  
Vol 34 (2) ◽  
pp. 300-309 ◽  
Author(s):  
Philip Boyce ◽  
Jemma Gilchrist ◽  
Nicholas J. Talley ◽  
Donna Rose

Objective: The irritable bowel syndrome (IBS) is a chronic and often disabling functional bowel disorder. Psychological treatments, in particular cognitive and behavioural interventions, have been shown to be effective for this disorder. The aim of this study was to test the efficacy of a cognitive-behaviour program. Method: Eight participants (seven female, one male) aged between 24 and 71 years, with a diagnosis of IBS according to the Rome criteria, were recruited from among the gastroenterology outpatients at Nepean Hospital, in Sydney, Australia. Participants were administered pretreatment on measures of psychological function and bowel symptom severity. Following a 2-week baseline period, participants began a structured psychological treatment comprising eight sessions of cognitive-behaviour therapy. Throughout treatment, participants maintained daily records of symptom severity and completed homework assignments to ensure treatment compliance. The pretreatment assessment measures were repeated 1 week post-treatment. Results: After treatment, five of the eight patients no longer met the Rome diagnostic criteria for IBS. There was no significant reduction in bowel symptom frequency. There were, however, significant improvements in the distress and disability associated with bowel symptoms. Anxiety and depression were also significantly reduced. Conclusions: Cognitive-behaviour therapy reduced the distress and disability associated with IBS, but not the frequency of bowel symptoms. This supports the proposed cognitive model for IBS, and cognitive-behaviour therapy appears to have its effect by altering the cognitive response to visceral hypersensitivity.


1991 ◽  
Vol 100 (2) ◽  
pp. 450-457 ◽  
Author(s):  
Elspeth Guthrie ◽  
Francis Creed ◽  
David Dawson ◽  
Barbara Tomenson

2013 ◽  
pp. 1120-1123
Author(s):  
Marie Boltz ◽  
Holly Rau ◽  
Paula Williams ◽  
Holly Rau ◽  
Paula Williams ◽  
...  

1992 ◽  
Vol 30 (2) ◽  
pp. 175-189 ◽  
Author(s):  
Edward B. Blanchard ◽  
Shirley P. Schwarz ◽  
Jerry M. Suls ◽  
Maryrose A. Gerardi ◽  
Lisa Scharff ◽  
...  

2005 ◽  
Vol 186 (6) ◽  
pp. 507-515 ◽  
Author(s):  
Francis Creed ◽  
Joy Ratcliffe ◽  
Lakshmi Fernandes ◽  
Stephen Palmer ◽  
Christine Rigby ◽  
...  

BackgroundIrritable bowel syndrome often leads to impaired functioning.AimsTo assess the contribution of psychiatric disorders to impaired outcome in severe irritable bowel syndrome.MethodPatients with severe irritable bowel syndrome entering a psychological treatment trial (n=257) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Outcomes were number of days of restricted activity, role limitation (physical) score of the Short Form Health Survey and costs.ResultsAt baseline, depressive disorder (29% of patients), panic (12%) and neurasthenia (35%) were associated with impairment; number of psychiatric disorders was associated in a dose–response fashion (P=0. 005). At follow-up, depressive disorder and neurasthenia were associated with role limitation score. Improved depression was associated with improved role functioning.ConclusionsDepressive, panic and neurasthenic disorders contribute to poor outcomes in severe irritable bowel syndrome, and appropriate treatment should be available to these patients.


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