Elyse R Thakur1,2,3, Jordan Shapiro4, Johanna Chan4, Mark A Lumley5, Jeffrey A Cully6,7,8, Andrea Bradford4, Hashem B El-Serag7,4. 1. VA South Central Mental Illness Research, Education and Clinical Center, (MEDVAMC 152), 2002 Holcombe Blvd, Houston, TX, 77030, USA. Elyse.Thakur@bcm.edu. 2. VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, (MEDVAMC 152), Michel E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX, 77030, USA. Elyse.Thakur@bcm.edu. 3. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. Elyse.Thakur@bcm.edu. 4. Gastroenterology and Hepatology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. 5. Department of Psychology, Wayne State University, Rm. 7204, 5057 Woodward Ave., Detroit, MI, 48202, USA. 6. VA South Central Mental Illness Research, Education and Clinical Center, (MEDVAMC 152), 2002 Holcombe Blvd, Houston, TX, 77030, USA. 7. VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, (MEDVAMC 152), Michel E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX, 77030, USA. 8. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
Abstract
BACKGROUND: Psychological treatments are efficacious for irritable bowel syndrome (IBS) in clinical trials; however, their effectiveness when conducted in gastroenterology practice settings is unclear. AIM: To perform a systematic review of the types and effects of psychological treatments for IBS conducted in gastroenterology clinics. METHODS: We searched PubMed, EMBASE, and Cochrane central register. Studies conducted in gastroenterology clinic settings with IBS patients who were clinically referred from gastroenterology were included. RESULTS: We identified 3078 citations, of which only eight studies were eligible. Seven studies compared psychological treatments (average n = 25.7; range 12-43) to controls (average n = 25.4 patients; range 12-47), whereas one study compared two active "bonafide" interventions. Psychological treatments varied (cognitive-behavioral therapy, guided affective imagery, mindfulness, hypnosis, biofeedback, emotional awareness training). However, across approaches, short-term benefits were seen. IBS symptoms improved significantly among patients in cognitive and behavioral therapies, mindfulness-based stress reduction, guided affective imagery, and emotional awareness training compared with controls; there was a similar trend for gut-directed hypnotherapy. Similarly, IBS symptoms improved in a study of two active biofeedback and hypnosis treatments. CONCLUSIONS: Evidence for the effectiveness of psychological treatment in gastroenterology practice is promising but limited. Study designs that involve a blending of efficacy and effectiveness components are needed.
BACKGROUND: Psychological treatments are efficacious for irritable bowel syndrome (IBS) in clinical trials; however, their effectiveness when conducted in gastroenterology practice settings is unclear. AIM: To perform a systematic review of the types and effects of psychological treatments for IBS conducted in gastroenterology clinics. METHODS: We searched PubMed, EMBASE, and Cochrane central register. Studies conducted in gastroenterology clinic settings with IBS patients who were clinically referred from gastroenterology were included. RESULTS: We identified 3078 citations, of which only eight studies were eligible. Seven studies compared psychological treatments (average n = 25.7; range 12-43) to controls (average n = 25.4 patients; range 12-47), whereas one study compared two active "bonafide" interventions. Psychological treatments varied (cognitive-behavioral therapy, guided affective imagery, mindfulness, hypnosis, biofeedback, emotional awareness training). However, across approaches, short-term benefits were seen. IBS symptoms improved significantly among patients in cognitive and behavioral therapies, mindfulness-based stress reduction, guided affective imagery, and emotional awareness training compared with controls; there was a similar trend for gut-directed hypnotherapy. Similarly, IBS symptoms improved in a study of two active biofeedback and hypnosis treatments. CONCLUSIONS: Evidence for the effectiveness of psychological treatment in gastroenterology practice is promising but limited. Study designs that involve a blending of efficacy and effectiveness components are needed.
Authors: G F Longstreth; C J Hawkey; E A Mayer; R H Jones; J Naesdal; I K Wilson; R A Peacock; I K Wiklund Journal: Aliment Pharmacol Ther Date: 2001-07 Impact factor: 8.171
Authors: Perjohan Lindfors; Peter Unge; Patrik Arvidsson; Henry Nyhlin; Einar Björnsson; Hasse Abrahamsson; Magnus Simrén Journal: Am J Gastroenterol Date: 2011-10-04 Impact factor: 10.864
Authors: Francis Creed; Lakshmi Fernandes; Elspeth Guthrie; Stephen Palmer; Joy Ratcliffe; Nicholas Read; Christine Rigby; David Thompson; Barbara Tomenson Journal: Gastroenterology Date: 2003-02 Impact factor: 22.682