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Cognitive behavior therapy superior to other psychotherapies for improving daily functioning in IBS
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Different psychotherapies showed comparable improvements in the mental health of patients with irritable bowel syndrome, but cognitive behavior therapy showed the greatest improvements in daily functioning, according to a recently published review and meta-analysis.
Cognitive behavior therapy “is an umbrella term for a number of different therapies, each of which is based on the idea that thoughts, feelings, physiology, and behavior are interrelated,” according to a press release. “Treatments are designed to help people develop alternative ways of thinking and behaving with the goal of reducing psychological distress and physiological arousal.”
While previous studies have demonstrated the general effectiveness of psychological therapies in alleviating the symptoms of IBS, researchers sought to determine the effects of specific psychological on daily functioning in this study.
“Evaluating daily function is important because it distinguishes between someone who experiences physical symptoms but can fully engage in work, school and social activities and someone who cannot,” Kelsey Laird, MS, a doctoral student in Vanderbilt’s clinical psychology program, said in a press release.
Laird and colleagues reviewed the relevant literature and identified 28 randomized controlled trials reporting the effects of psychological therapies on mental health, and 18 randomized controlled trials reporting outcomes on daily functioning in adults with IBS. Cognitive behavior therapy (CBT) was the most common, followed by hypnosis, psychodynamic therapy and relaxation.
Psychotherapies in general showed significantly greater improvements in both mental health and daily functioning compared with a variety of controls. While different psychotherapies showed comparable improvements in mental health, CBT showed the greatest improvements in daily functioning, which reached statistical significance when compared with relaxation therapy (P = .004), which itself did not demonstrate significant improvements in either mental health or daily functioning. Psychodynamic therapies were also significantly better at improving daily functioning compared with relaxation (P = .012), and hypnotherapy approached significance in its superiority vs. relaxation.
The fact that CBT often involves “exposure,” or encouraging patients to confront uncomfortable situations in their daily routines, may explain why this psychotherapeutic modality is superior in improving daily functioning, the researchers wrote.
“Encouraging individuals to gradually confront such situations may increase their ability to participate in a wider range of activities,” Laird said in the press release. “But more research is needed before we can say why CBT appears more effective for improving functioning in IBS compared to other therapy types.”
The researchers also noted that “somewhat surprisingly, improvements to daily functioning were slightly but significantly larger for interventions delivered online compared to those delivered in-person, [which] could be good news for efforts to enhance dissemination of treatment.” However, this was based on just two trials, both of which involved CBT with exposure, which could account for this effect, they concluded. – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
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