Meta-analysis shows long-term benefit of psychological therapies in IBS patients
Psychological therapies were found to provide short- and long-term reductions in gastrointestinal symptoms in adults with irritable bowel syndrome, according to the results of a recent meta-analysis.
“Our study is the first one that has looked at long-term effects,” Lynn S. Walker, PhD, professor of pediatrics at Vanderbilt University Medical Center, said in a press release. “We found that the moderate benefit that psychological therapies confer in the short term continue over the long term. This is significant because IBS is a chronic, intermittent condition for which there is no good medical treatment.”
Walker and colleagues searched relevant literature published through August 15, 2015, and performed a meta-analysis of 41 randomized controlled trials comparing the efficacy of psychological therapy (n = 1,183) and a number of control conditions (n = 1,107) for treating GI symptoms in adults with IBS. Control conditions included supportive therapy, education, sham treatments, online discussion forums, enhanced medical care, treatment as usual, symptom monitoring and wait-list controls. Studies that compared only two types of psychotherapies were not eligible for inclusion.
Psychotherapies were effective at improving GI symptoms immediately after treatment compared with a mixed group of active and non-active control conditions (P < .001), and there was no evidence of significant publication bias at first follow-up after treatment.
“The average individual assigned to psychotherapy experienced a greater decrease in GI symptoms than 75% of individuals assigned to a control condition,” the researchers wrote.
In the short-term, defined as between 1 and 6 months after treatment, and in the long-term, defined as 6 months to 1 year after treatment, psychotherapy had a medium effect on improving GI symptoms compared with control conditions (P < .001), and there was again no evidence of significant publication bias.
“Cognitive, relaxation, and hypnosis therapies were the most commonly tested treatment modalities within our eligible sample of trials,” the researchers wrote. “The results suggest these three therapies may be equally effective at improving GI symptoms.
“Western medicine often conceptualizes the mind as separate from the body, but IBS is a perfect example of how the two are connected,” Kelsey Laird, a doctoral student in Vanderbilt’s clinical psychology program, said in the press release. “Gastrointestinal symptoms can increase stress and anxiety, which can increase the severity of the symptoms. This is a vicious cycle that psychological treatment can help break.”
Laird added that in an ongoing follow-up study she is investigating the effect that psychological therapies have on patients’ ability to function. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.