Psychological Outcomes of a Cognitive Behavioral Therapy for Youth with Inflammatory Bowel Disease: Results of the HAPPY-IBD Randomized Controlled Trial at 6- and 12-Month Follow-Up

Abstract

Youth with inflammatory bowel disease (IBD) often experience psychological difficulties, such as anxiety and depression. This randomized controlled study tested whether a 3-month disease-specific cognitive behavioral therapy (CBT) in addition to standard medical care versus standard medical care only was effective in improving these youth's psychological outcomes. As this study was aimed at prevention, we included 70 youth (10-25 years) with IBD and symptoms of subclinical anxiety and/ or depression, and measured psychological outcomes at 6-and 12-month follow-up. In general, participants in both groups showed improvements in anxiety, depression, health-related quality of life, social functioning, coping, and illness perceptions, sustained until 12 months follow-up. Overall, we found no differences between those receiving additional CBT and those receiving standard medical care only. We assume that this can be explained by the perceived low burden (both somatically and psychologically) or heightened awareness of psychological difficulties and IBD. ClinicalTrials.gov NCT02265588.

Burden of comorbid anxiety and depression in patients with inflammatory bowel disease: a systematic literature review

“…It is also important to note that new studies have been published since this systematic review was completed. For example, a randomized controlled trial of young adults and adolescents (n = 70) found no evidence that disease-specific CBT along with standard medical care improved psychological symptoms or health-related QoL [102,103]. The authors concluded that this could be due to most patients having no or only mild IBD symptoms at baseline and noted that it is still unclear which patients will benefit most from CBT and how the intervention should be delivered.…”

The physiological and psychological effects of cognitive behavior therapy on patients with inflammatory bowel disease before COVID-19: a systematic review

“…The 11 included studies were randomized controlled trials investigating the physiological or psychological effects of CBT on IBD patients from 2007 to 2019. Four of these studies are from the United States [ 41 – 44 ], one from Australia with two follow-up times [ 45 , 46 ], two from the Netherlands [ 47 , 48 ], one from Ireland [ 49 ], one from England [ 50 ] and one from New Zealand [ 51 ]. The sample size of the studies ranged from 41 to 199, making a total of 995 individuals two studies used the same cohort).…”

“…Only two studies included only 41 participants [ 41 , 44 ]. All the included studies reported follow-up data for at least 3 months, with six of them followed for 12 months or more [ 41 , 43 , 45 – 47 , 50 ], and the longest took 2 years [ 45 ]. Details can be found in Table 1 .…”

“…Six studies included people over the age of 18 [ 42 , 45 , 46 , 49 – 51 ]. (three of which restricted the maximum age to 65 [ 49 – 51 ]), three studies only targeted people under the age of 18 [ 41 , 43 , 44 ], and two studies included participants aged 10–25 years [ 47 , 48 ]. In all but two studies [ 45 , 46 ], the number of female participants greatly exceeded men.…”

“…In all but two studies [ 45 , 46 ], the number of female participants greatly exceeded men. All studies included participants with CD and UC, and four of the studies also included a small number of participants from IBD-U [ 42 , 47 , 48 , 51 ]. All but two studies [ 49 , 50 ] had more Crohn's patients than ulcerative colitis.…”