Cognitive-behavioural therapy in patients with inflammatory bowel diseases: A systematic review and meta-analysis

Abstract

Aims: This systematic review and meta-analysis aimed to evaluate the effects of cognitive-behavioural therapy in patients with inflammatory bowel diseases.

Methods: Cochrane Library, Web of Science, Pubmed, EMBASE, and CINAHL were searched up to June 2017, as well as grey literature and databases hand searches. Quality assessment, heterogeneity, sensitivity analysis, and publication bias were performed. Stata12.0 software was used for pooled estimates.

Results: Seven eligible reports were included in the final analysis. Inflammatory Bowel Disease Questionnaire score was higher in the cognitive-behavioural therapy group than in the control group at the final follow-up in inflammatory bowel disease patients (P = 0.008). There was no statistically significant difference in the Crohn's Disease Activity Index (P = 0.751), Simple Clinical Colitis Activity Index score (P = 0.747), State Anxiety score (P = 0.988), Trait Anxiety score (P = 0.681), and Perceived Stress Questionnaire score (P = 0.936) at the final point of follow-up. A funnel plot showed no publication bias (P = 0.98).

Conclusion: Cognitive-behavioural therapy appeared to support higher quality of life in inflammatory bowel disease patients compared with a control group at the final follow-up point but had no effect on disease activity, anxiety, or perceived stress in patients with inflammatory bowel disease. Cognitive-behavioural therapy can be an acceptable adjunctive therapy for inflammatory bowel disease patients, but the effect of cognitive-behavioural therapy is limited.

Keywords: behavior therapy; cognitive; inflammatory bowel diseases; meta-analysis; nursing; quality of life.