INSPIRE study: Does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or crohnʼs disease? A randomized controlled trial

Abstract

Stress management psychotherapy does not appear to improve disease course or reduce relapse in patients with IBD. It might improve quality of life, particularly in patients with UC.

Effect of psychological therapy on disease activity, psychological comorbidity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis

“…Of these, a further 32 were excluded for various reasons leaving 14 studies eligible for data extraction. [23][24][25][26][27][28][29][30][31][32][33][40][41][42] Agreement between reviewers for eligibility assessment was excellent (Kappa statistic = 0.91). Detailed study characteristics are provided in Table 1, and risk of bias across all studies is reported in page 1 of the webappendix.…”

“…However, only four of the studies we identified performed this. 28,30,33,42 The included studies employed various methods of handling the control arms, which may mean that pooling the data from them could be viewed as inappropriate. The fact that duration of follow-up was not uniform between eligible studies may also mean that a significant benefit of psychological therapies, which is perhaps timedependent, has been overlooked.…”

“…30,31 Only one of these studies reported dichotomous data concerning the efficacy of psychological therapy in the induction of remission of active IBD. 30 In total, 12 (21.1%) of 57 patients undergoing psychological therapy entered clinical remission, compared with 2 (3.5%) of 57 patients in the control group, after 18 months of follow-up.…”

“…In terms of effect on other outcomes, including change in clinical disease activity indices, 30 depression, 31 anxiety, 31 and perceived stress scores, 31 each of these were only reported in one RCT, and therefore formal meta-analysis was not possible. Psychological therapy was not associated with an improvement in any of these outcomes, when compared with control, in patients with active IBD.…”

“…22 However, the authors included quasirandomised and non-randomised studies in their analysis and there have been numerous additional studies published in the intervening years. [23][24][25][26][27][28][29][30][31][32][33] We therefore aimed to re-examine the efficacy of psychological therapies in IBD, with particular emphasis on their effects on disease activity indices, psychological wellbeing, including anxiety, depression, and perceived stress, and quality of life.…”