Selected trials of cognitive behaviour therapy (CBT) in irritable bowel syndrome (IBS)

Trial	Design and numbers	Intervention	Outcome
Bennett and Wilkinsonw12	RCT; 12 CBT, 12 usual care	Eight week package: stress management training, cognitive therapy, and contingency management v medical treatment (aperients and antispasmodics)	Anxiety reduced in treatment group but not in control group; both achieved improvement in IBS symptoms, restriction of activities, and fatigue
Lynch and Zamblew13	RCT; 12 CBT, 12 waiting list	Coping skills, assertiveness training, education, and progressive relaxation v waiting list controls	Significantly greater improvement of IBS symptoms and anxiety in treatment group
Greene and Blanchardw14	RCT; 10 CBT, 10 symptom monitoring	Individualised CBT for 10 sessions v daily gastrointestinal symptom monitoring over eight weeks	80% of treatment group showed clinical improvement compared with 10% of controls. Sustained results at three month follow-up
Guthrie et alw15	RCT; n=102	Psychotherapy v “supportive listening,” 12 week study. After study, 33 patients from control group accepted psychotherapy	Psychotherapy significantly superior in terms of physical and psychological symptoms (for women; trend in men). Results sustained at 12 month follow-up
Boyce et alw16	RCT; n=105	Three arm trial: all groups received standard care, plus either CBT or relaxation training.Patients with “resistant IBS” not included	Significant improvements for all groups in IBS symptoms, physical/social functioning and general wellbeing, but no significant differences between groups. No difference at 12 month follow-up

RCT=randomised controlled trial.