Longitudinal Results of Cognitive Behavioral Treatment for Youths with Inflammatory Bowel Disease and Depressive Symptoms

Abstract

Youths with chronic physical illnesses face increased rates of psychological problems and the burden of coping with physical illness-related challenges. The following data describes treatment outcome maintenance results from a randomized clinical trial investigating the impact of a cognitive behavioral intervention Primary and Secondary Control Enhancement Therapy-Physical Illness (PASCET-PI) as compared to treatment as usual (TAU) on youths with inflammatory bowel disease (IBD). Forty-one participants aged 11-17 with IBD and concurrent depressive symptomatology were randomized to PASCET-PI (n = 22) or TAU (n = 19). Self-reported depressive features, global functioning, and DSM-IV depressive symptomatology were assessed immediately post-treatment (T2), followed by assessments at 6-months (T3) and 12-months (T4) post-treatment initiation. Repeated measure models revealed significantly improved global psychosocial functioning in youths randomized to PASCET-PI compared to youths randomized to TAU. Improvements in self-reported depressive features and DSM-IV depressive symptoms were found at the trend level for youths randomized to PASCET-PI relative to those receiving TAU. Effect size estimates for all outcome variables suggested large to medium treatment effects.

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

“…46,51,52 In addition to the outcomes addressed in this systematic review and meta-analysis, fatigue is now recognised as an increasing problem in people with IBD, and is more prevalent than in the general population, affecting up to 40% of patients. 53,54 Furthermore, fatigue may be associated with depression and reduced quality of life, independent of disease activity.…”

Pediatric inflammatory bowel disease and depression

“…In a longitudinal study assessing the effects of CBT on pediatric IBD patients with a 12 month follow-up, there was significant improvement in self-reported depressive severity and global psychosocial functioning in youths randomized to CBT. (55) For these studies, the CBT model, originally for depression treatment (48), was made feasible for this physically ill population through several modifications: 1) Illness perceptions were identified and targeted by the intervention with an emphasis on improving a sense of control; 2) IBD-related maladaptive behaviors such as medical non-adherence were addressed; 3) Sessions with parents or caretakers were incorporated into individual child therapy sessions in developmentally appropriate ways; and 4) the intervention was accessible with phone sessions and/or face-to-face sessions coordinated with medical care. (56)…”

Stability of Emotional and Behavioral Functioning in Youth with Inflammatory Bowel Disease

“…More specifically, youth may benefit from initial evaluation with a mental health professional who can assess emotional and behavioral functioning; those who have more significant emotional symptoms may require focused intervention to improve. Cognitive-behavioral therapy has been shown to be effective for reducing symptoms of depression in youth with IBD (Szigethy et al, 2009; Thompson, Craig, Crawford, et al, 2012). At a systems level, results support the utility of multidisciplinary healthcare teams to address the range of difficulties faced by youth with IBD.…”