Table 1.
Summary of evidence for the use of psychotherapies in patients with inflammatory bowel disease.
| Psychotherapy | Type of study | N | Outcome in patients | Reference |
|---|---|---|---|---|
| Stress management | RCT | 58 | Improved QOL in UC patients. | Boye et al[136] |
| RCT | 39 | Decreased levels of anxiety, pain, and stress as well as improved QOL and mood. | Mizrahi et al[137] | |
| Clinical study | 45 | Alleviated fatigue, constipation, abdominal pain, and distended abdomen. | García-Vega and Fernandez-Rodriguez[138] | |
| Clinical study | 36 | Reduced the relapse rate of IBD in the next 12 months. | Keefer et al[139] | |
| CBT | RCT | 57 | Continuously improved anxiety and depression. | Díaz Sibaja et al[141] |
| RCT | 199 | Improved health-related QOL at 12 weeks after baseline but did not maintain at 6 months. | McCombie et al[142] | |
| RCT | 176 | No changes in the course of IBD in 24 months. | Mikocka-Walus et al[147] | |
| RCT | 174 | Did not affect the remission rate, anxiety, depression, or coping but improved the QOL in patients with high mental health needs. | Mikocka-Walus et al[143] | |
| RCT | 120 | Reduced stress and the number of relapses self-reported by patients, and improved QOL. | Bernabeu et al[148] | |
| Pilot feasibility study | 20 | Improved sleep continuity, dysfunctional sleep-related beliefs, and reduced IBD disease activity. | Salwen-Deremer et al[146] | |
| Pilot feasibility study | 22 | Alleviated fatigue and increased QOL. | Artom et al[144] | |
| Clinical study | 20 | Improved pain self-efficacy and QOL, as well as reduced depression, anxiety, and pain catastrophizing and avoidance resting behavior. | Sweeney et al[145] | |
| Clinical study | 28 | Decreased disease-related worries and concerns. | Mussell et al[140] | |
| MBI | RCT | 55 | Relieved stress in patients who flared but had no effect on flare-ups in UC patients in remission. | Jedel et al[149] |
| RCT | 44 | Improved score of depression, trait anxiety, and dispositional mindfulness. | Schoultz et al[150] | |
| RCT | 29 | Improved psychological and physical symptoms, QOL, and C-reactive protein. | Gerbarg et al[151] | |
| MCT | RCT | 66 | Improved IBDQ scores in patients with IBS-type symptoms but did not affect the relapse rate. | Berrill et al[152] |
| RCT | 116 | Significantly reduced disease activity, improved QOL, alleviated psychological symptoms and fatigue, and increased mindfulness disposition. | Goren et al[158] | |
| Hypnosis | RCT | 54 | Prolonged remission in patients with quiescent ulcerative colitis. | Keefer et al[153] |
| Clinical study | 15 | Reduced corticosteroid requirements in patients on corticosteroids but not responding to medication at baseline. | Miller and Whorwell[154] | |
| RCT | 17 | Decreased pulse and median serum IL-6 concentration as well as the rectal mucosal release of substance P, histamine, IL-13, and blood flow. | Mawdsley et al[155] | |
| RCT | 63 | Relieved IBS-type symptoms in patients with quiescent IBD but was not superior to standard medical treatment. | Hoekman et al[156] | |
| STPP | RCT | 60 | 8-week STPP + standard medical therapy effectively increased the steroid-free remission rates compared to standard medical therapy alone. | Milo et al[157] |
CBT: Cognitive behavioral therapy; IBD: Inflammatory bowel disease; IBDQ: Inflammatory Bowel Disease Questionnaire; IBS: Irritable bowel syndrome; IL-6: Interleukin-6; IL-13: Interleukin-13; MBI: Mindfulness-based interventions; MCT: Multi-convergent therapy; QOL: Quality of life; RCT: Randomized controlled trial; STPP: Short-term psychoanalytic psychotherapy; UC: Ulcerative colitis.