Self-help Cognitive Behavioral Therapy Improves Health-Related Quality of Life for Inflammatory Bowel Disease Patients: A Randomized Controlled Effectiveness Trial

The Effect of Psychotherapy on Quality of Life in IBD Patients: A Systematic Review

“…The 31 eligible studies are displayed in Table 2 . Ten showed a significant positive effect regarding the impact of psychotherapeutic interventions on QoL, 10 , 18 , 19 , 23 , 26 , 31 , 34 , 36 , 37 , 46 and 1 study only reported raw data but showed, after statistical testing, a significant effect. 47 Six studies reported mixed results; 21 , 25 , 28 , 30 , 44 , 39 1 study showed significant improvements in QoL scores in the intervention group but no significant difference compared with the control group, 39 2 studies displayed significant effects in the per-protocol analysis but not in the intention-to-treat analysis, 25 , 28 2 studies reported improvement in only some domains, 30 , 44 and 2 studies concluded that improvements were only witnessed in a subgroup.…”

“…Concerning methodology, 23 studies were RCTs 18-26 , 28 , 31 , 32 , 36 , 39 – 43 , 45 of whom 4 were pilot RCTs. 27 , 33 , 34 , 38 One study was partially randomized, 30 6 studies were prospective observational studies, 10 , 29 , 35 , 37 , 46 , 47 and 1 prospective observational study used a control group.…”

“…No studies were graded as being of high quality. Eight studies were of moderate quality, 18 , 19 , 21-23 , 36 , 41 , 45 8 studies were of low quality, 24 , 25 , 28 , 32 , 39 , 40 , 42 , 43 and 15 studies were assessed as being of very low quality, 10 , 20 , 26 , 27 , 29-31 , 33-35 , 37 , 38 , 44 , 46 , 47 according to the GRADE criteria. 17…”

“…Thirteen studies included IBD patients in remission or with very mild disease only, or described results when disease worsened: The overall effect reported on patients in remission was ambiguous, with 4 studies reporting a (temporarily) positive effect, 23 , 34 , 36 , 37 5 studies reporting no significant effect, 21 , 22 , 32 , 40 , 45 , 49 3 studies reporting mixed results, 28 , 30 , 39 and 1 study that did not perform statistical testing because of the small sample size. 38 Four studies focused on IBD patients with active disease only 26 , 47 or described the impact of psychotherapy during a flare, 21 , 36 and these 4 studies showed a significant positive effect of psychotherapy on QoL. Mizrahi et al 26 showed in an RCT on stress management a significant difference in the effect of intervention over time in IBD patients compared with control patients after 5 weeks ( P = 0.014; mean difference in IBDQ total score = 13.33 [15.45]; P = 0.002).…”

“…In the small observational study of Miller and Whorwell, 47 6,7% of the therapy-refractory IBD patients scored their QoL at baseline as good or excellent compared with 80% who scored their QoL similarly after hypnotherapy (calculated P = 0.003), with a mean follow-up of 5.4 years. During a flare, QoL in IBD patients remained significantly improved post-cognitive-behavioral therapy (CBT) treatment compared with control patients in an RCT conducted by Hunt et al, 36 but no measures of the short IBDQ scores were reported. Jedel et al 21 observed significantly better IBDQ total scores in patients with active disease in a mindfulness-based stress-reduction program compared with matched control patients at 12 months (mean difference mixed model = 0.15 [0.04-0.26]; P = 0.001).…”