Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Feb;24(1):127-135.
doi: 10.1007/s12529-016-9580-9.

Cognitive-Behavioural Therapy for Inflammatory Bowel Disease: 24-Month Data from a Randomised Controlled Trial

Antonina Mikocka-Walus  1   2   3 , Peter Bampton  4   5 , David Hetzel  6 , Patrick Hughes  7 , Adrian Esterman  8   9 , Jane M Andrews  4   6   7
Affiliations
Randomized Controlled Trial

Cognitive-Behavioural Therapy for Inflammatory Bowel Disease: 24-Month Data from a Randomised Controlled Trial

Antonina Mikocka-Walus et al. Int J Behav Med. 2017 Feb.

Abstract

Purpose: There is ongoing controversy on the effectiveness of psychotherapy in inflammatory bowel disease (IBD). In the few small studies, cognitive-behavioural therapy (CBT) has been shown to alleviate symptoms of anxiety or depression. However, there is little research on the impact of CBT on physical outcomes in IBD and no studies on long-term effectiveness of CBT.

Methods: The present two-arm pragmatic randomised controlled trial aimed to establish the impact of CBT on disease course after 24 months of observation. The study compared standard care plus CBT (+CBT) with standard care alone (SC). CBT was delivered over 10 weeks, face-to-face (F2F) or online (cCBT). The data were analysed using linear mixed-effects models.

Results: CBT did not significantly influence disease activity as measured by disease activity indices at 24 months (Crohn's Disease Activity Index (CDAI), p = 0.92; Simple Clinical Colitis Activity Index (SCCAI), p = 0.88) or blood parameters (C-reactive protein (CRP), p < 0.62; haemoglobin (Hb), p = 0.77; platelet, p = 0.64; white cell count (WCC), p = 0.59) nor did CBT significantly affect mental health, coping or quality of life (all p > 0.05).

Conclusions: Therefore, we conclude that CBT does not influence the course of IBD over 24 months. Given the high rate of attrition, particularly in the CBT group, future trials should consider a personalised approach to psychotherapy, perhaps combining online and one-to-one therapist time.

Keywords: Cognitive-behavioural therapy; Disease course; Inflammatory bowel disease.

PubMed Disclaimer

Conflict of interest statement

Compliance with Ethical Standards All authors declare that they have no competing interests to report. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Royal Adelaide Hospital and the University of South Australia Research Ethics Committees in August 2009. Informed consent was obtained from all individual participants included in the study. The privacy rights of participants were observed.

Figures

Fig. 1
Fig. 1
CONSORT diagram showing the flow of participants through the study
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Loftus EV., Jr Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology. 2004;126(6):1504–17. doi: 10.1053/j.gastro.2004.01.063. - DOI - PubMed
    1. CCFA. About the Epidemiology of IBD. Crohn’s and Colitis Foundation of America. 2012. http://www.ccfa.org/resources/epidemiology.html. 2015.
    1. Rocchi A, Benchimol EI, Bernstein CN, Bitton A, Feagan B, Panaccione R, et al. Inflammatory bowel disease: a Canadian burden of illness review. Can J Gastroenterol. 2012;26(11):811–7. doi: 10.1155/2012/984575. - DOI - PMC - PubMed
    1. CCA. About Crohn’s and Colitis. Crohn’s & Colitis Australia. 2015. https://www.crohnsandcolitis.com.au/about-crohns-colitis/. 2015.
    1. Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger & Fordtran’s gastrointestinal and liver disease: pathophysiology, diagnosis, management. 8. Philadelphia: Saunders; 2006.

Publication types