Patients with IBD in remission who received solution-focused psychotherapy had less severe symptoms of fatigue and improved quality of life compared with those who did not in a recent study.
Researchers randomly assigned 98 patients with IBD in remission to standard care (n=49) or solution-focused therapy (SFT) (n=49) for 3 months, with 6 months of additional follow-up. All participants scored at least 35 on the Checklist Individual Strength – Fatigue (CIS-fatigue) test.
SFT consisted of six group sessions of psychotherapy across 3 months, along with a booster session at month 6, with a focus on fatigue management. Patient reports on quality of life (QoL) and fatigue were assessed at baseline and at 3, 6 and 9 months, as were depression and anxiety symptoms, medication usage and side effects, disease activity, sleep quality and levels of C-reactive protein, hemoglobin and leucocytes.
After therapy, more SFT patients had CIS-fatigue scores below 35 than those under standard care (39% of cases vs. 18%; P=.03). After 6 months of follow-up, more SFT recipients had low fatigue scores (34% vs. 21%; P=.19), with similar proportions observed at 9 months (30% vs. 26%; P=.66).
Both groups experienced reduced anxiety, as measured by the Hospital Anxiety and Depression Scale (P<.001 overall from baseline to follow-up completion). SFT recipients experienced greater reductions in depression symptoms from baseline at 3 months (P=.03 vs. standard care), but not at 9 months (P=.7). No differences were observed between groups or in individual groups, in disease activity, medication use or side effects or laboratory parameters.
“SFT has a significant positive effect on fatigue and QoL in patients with IBD, and offers a management strategy for these patients,” the researchers concluded. “Although very effective, this effect declined during follow-up. We argue that this fatigue management, especially in groups, should be part of the IBD treatment. Further research should focus on when and for how long fatigue management should be implemented.”
Disclosure: Researcher Christien J. van der Woude reported serving on advisory boards for Abbott Laboratories, Centocor, Falk Benelux, Ferring and Merck and receiving compensation.