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

Abstract

(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

Psychological burden and quality of life in newly diagnosed inflammatory bowel disease patients

“… Gracie et al (2018) demonstrated a bi-directional relationship between disease activity and psychological disorders in CD and UC, highlighting the potential impact of brain-gut axis activity on the natural history of IBD. Different studies have demonstrated the role of psychological therapies on quality of life in patients with IBD ( Knowles et al, 2013 ; Neilson et al, 2016 ; Gracie et al, 2017 , 2018 ; Bernabeu et al, 2021 ). These results reinforce the need for integration therapies that target inflammatory disease activity with novel interventions that aim to improve psychological well-being in patients with IBD.…”

Evaluation of a Multimodal Stress Management and Comprehensive Lifestyle Modification Program on Quality of Life and Gastrointestinal Symptoms in Patients with Crohn’s Disease: A Randomized Controlled Pilot Trial with 9-Month Follow-Up

“…However, most of these studies focused either on IBD in general (and not on CD specifically) or on single interventions rather than multimodal and comprehensive approaches. In particular, multicomponent psychological group interventions in IBD [26, 27] and a cognitive behavioral therapy in combination with mindfulness in CD [28] showed improvements in QoL. In addition, other research groups were able to show improvements also in stress levels as well as in anxiety and depression symptoms in patients with IBD through a combination of breathing exercises, meditation, and relaxation compared to the waiting list CG [29].…”

“…The trends we found were in line with the observations of other working groups. Single previous studies [26, 27, 35, 36] and a systematic review [33] on mindfulness-based or stress management-based interventions, as well as a program focusing on nutrition and exercise in patients with IBD [32], did not show significant impacts of such interventions on disease activity in IBD. However, stress management, relaxation, lifestyle modification, and yoga interventions resulted at least in improvement in clinical disease activity, primarily by reducing abdominal pain [31, 37, 38].…”

The Association between Temperament, Chronotype, Depressive Symptoms, and Disease Activity among Patients with Inflammatory Bowel Disease—A Cross-Sectional Pilot Study

“…CD and UC are considered psychosomatic diseases determined by biopsychosocial factors. Thus, IBDs require multidisciplinary care [50,51]. It appears that the prevalence of depressive and anxiety symptoms is similar between IBDs and other chronic somatic diseases [52].…”

“…Yet, the assessment of depressive symptoms should probably be considered as a standard element of disease activity evaluation, since the relationship appears to be bidirectional [5]. Taking into account the temperamental traits may help in providing patient-tailored therapeutic interventions and increase their effectiveness [50]. This appears important, since the history of patients' therapy has been associated with their psychosocial functioning [53].…”