Document Detail


Self-administered cognitive behavior therapy for moderate to severe irritable bowel syndrome: clinical efficacy, tolerability, feasibility.
MedLine Citation:
PMID:  18524691     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Given the limitations of conventional therapies and restrictions imposed on newer pharmacologic agents, there is an urgent need to develop efficacious and efficient treatments that teach patients behavioral self-management skills for relieving irritable bowel syndrome (IBS) symptoms and associated problems.
METHODS: Seventy-five Rome II diagnosed IBS patients (86% female) without comorbid gastrointestinal disease were recruited from local physicians and the community and randomized to either 2 versions of cognitive behavior therapy (CBT) (10-session, therapist-administered CBT vs 4-session, patient-administered CBT) or a wait list control (WLC) that controlled for threats to internal validity. Final assessment occurred 2 weeks after the 10-week treatment phase ended. Outcome measures included adequate relief from pain and bowel symptoms, global improvement of IBS symptoms (CGI-Improvement Scale), IBS symptom severity scale (IBS SSS), quality of life (IBSQOL), psychological distress (Brief Symptom Inventory), and patient satisfaction (Client Satisfaction Scale).
RESULTS: At week 12, both CBT versions were significantly (P < .05) superior to WLC in the percentage of participants reporting adequate relief (eg, minimal contact CBT, 72%; standard CBT, 60.9%; WLC, 7.4%) and improvement of symptoms. CBT-treated patients reported significantly improved quality of life and IBS symptom severity but not psychological distress relative to WLC patients (P < .0001).
CONCLUSIONS: Data from this pilot study lend preliminary empirical support to a brief patient-administered CBT regimen capable of providing short-term relief from IBS symptoms largely unresponsive to conventional therapies.
Authors:
Jeffrey M Lackner; James Jaccard; Susan S Krasner; Leonard A Katz; Gregory D Gudleski; Kenneth Holroyd
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2008-06-04
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  6     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-10-23     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  899-906     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, University at Buffalo, SUNY, Buffalo, New York, USA. lackner@buffalo.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cognitive Therapy*
Female
Humans
Irritable Bowel Syndrome / psychology*,  therapy*
Male
Middle Aged
Patient Satisfaction / statistics & numerical data
Pilot Projects
Quality of Life
Random Allocation
Self Administration
Severity of Illness Index
Treatment Outcome
Grant Support
ID/Acronym/Agency:
67878//PHS HHS; R03 DK067878-02/DK/NIDDK NIH HHS; U01 DK077738-01A1/DK/NIDDK NIH HHS
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