Effects of cognitive behavioral therapy on mental health and quality of life in inflammatory bowel disease patients: A meta-analysis of randomized controlled trials

The Impact of Group Cognitive Behavioral Psychotherapy on Disease Severity and Psychosocial Functioning in Patients With Inflammatory Bowel Disease: A Randomized Controlled Study

BACKGROUND AND AIMS

Patients with inflammatory bowel disease (IBD) often report symptoms of anxiety and depression as well as impaired quality of life (QoL). To date, there are few studies on the effect of psychotherapy on psychological functioning and clinical outcome in patients with IBD. The aim of this prospective, randomized, controlled study was to investigate the effect of a brief psychotherapeutic intervention on psychological distress, QoL, sexual functioning, and inflammation and disease activity indices in patients with IBD.

METHODS

Participants were randomized to receive either group cognitive behavioral therapy or treatment as usual (controls) and were assessed at baseline and after 6 months using psychometric instruments to assess psychological distress, QoL, and sexual functioning. In addition, laboratory measurements, including levels of C-reactive protein (CRP), cytokines, and calprotectin, and calculations of disease activity indices were performed during the 2 study periods.

RESULTS

A total of 80 participants took part in the study. Patients who received psychotherapy reported a significant decrease in anxiety and depression symptoms; a significant improvement in physical functioning, general health, vitality, social functioning, and mental health; and a decrease in physical pain and role limitations caused by emotional problems. CRP levels and the Crohn's Disease Activity Index (CDAI) also decreased significantly at follow-up compared to controls.

CONCLUSIONS

Group cognitive behavioral therapy is proving to be an important component of holistic care for IBD patients, as it can significantly improve not only patients' psychosocial functioning but also their clinical course by inhibiting inflammation and reducing disease activity.

CLINICAL TRIAL REGISTRATION

clinicaltrials.gov: NCT03667586.

Abdominal Pain in Inflammatory Bowel Disease-Epidemiology, Pathophysiology, and Management: A Narrative Review

Abdominal pain is a major symptom of inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, and has a significant impact on patients' quality of life. Given the evolving understanding of IBD pathology and management strategies, there is an urgent need to review the recent research findings. In this review, we have analyzed the epidemiology, pathophysiology, and management of abdominal pain in IBD over the past decade. We draw on the current literature and highlight emerging trends, challenges, and advances in this field. By synthesizing key findings, this review provides insights into the complex interplay between abdominal pain, disease progression, and therapeutic interventions for IBD.

Impact of mental health comorbidity in children and young adults with inflammatory bowel disease: a UK population-based cohort study

OBJECTIVE

To evaluate the impact of mental health comorbidity in children and young adults with inflammatory bowel disease (IBD).

DESIGN

Retrospective observational study.

SETTING

Representative population, routinely collected primary care data from the UK Optimum Patient Care Research Database (2015-2019).

PARTICIPANTS

Patients with IBD aged 5-25 years with mental health conditions were compared with patients with IBD of the same age without mental health conditions.

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcomes comprised quality-of-life indicators (low mood, self-harm, parasuicide, bowel symptoms, absence from school or work, unemployment, substance use and sleep disturbance), IBD interventions (medication, abdominal surgery, stoma formation and nutritional supplements) and healthcare utilisation (primary care interactions and hospital admissions).

RESULTS

Of 1943 individuals aged 5-25 years with IBD, 295 (15%) had a mental health comorbidity. Mental health comorbidity was associated with increased bowel symptoms (adjusted incident rate ratio (aIRR) 1.82; 95% CI 1.33 to 2.52), sleep disturbance (adjusted HR (aHR) 1.63; 95% CI 1.02 to 2.62), substance use (aHR 3.63; 95% CI 1.69 to 7.78), primary care interactions (aIRR 1.33; 95% CI 1.12 to 1.58) and hospital admissions (aIRR 1.87; 95%CI 1.29 to 2.75). In individuals ≥18 years old, mental health comorbidity was associated with increased time off work (aHR 1.55; 95% CI 1.21 to 1.99).

CONCLUSIONS

Mental health comorbidity in children and young adults with IBD is associated with poorer quality of life, higher healthcare utilisation and more time off work. It is imperative that affected young patients with IBD are monitored and receive early mental health support as part of their multidisciplinary care.

TRIAL REGISTRATION NUMBER

The study protocol was specified and registered a priori (ClinicalTrials.gov study identifier: NCT05206734).