Table 3.
Randomized controlled studies investigating the effects of cognitive behavioral therapy in patients with irritable bowel syndrome.
| Study | Population | Variables | Intervention | Results |
|---|---|---|---|---|
| Greene & Blanchard (1994) Cognitive therapy for irritable bowel syndrome. J Consult Clin Psychol. (39) | 20 (75% female) | GI symptoms | 2 weeks: 2x 1 h intervention/week, 6 weeks: 1x 1 h intervention/week vs. control group with symptom monitoring | Post treatment: 80% of CBT group and 10% of control group with significant improvement of GI symptoms. |
| Payne & Blanchard (1995) A controlled comparison of cognitive therapy and self-help support groups in the treatment of irritable bowel syndrome. J Consult Clin Psychol. (33) | 22 (82% female) | Individual GI symptoms Composite index for GI symptoms |
2 weeks: 2x 1 h intervention/week, 6 weeks: 1x1 h intervention/ week vs. symptom-monitoring waiting-list control | 50% reduction of gastrointestinal symptoms, anxiety, and depression in the CBT-group compared to baseline symptom score. |
| Vollmer & Blanchard (1998) Controlled comparison of individual versus group cognitive therapy for irritable bowel syndrome. Behav Ther. (40) | 34 (76% female) | Clinical symptoms | 10 weeks: 1 h individual CBT session/week or 10 weeks: 90 min group CBT session/week or monitoring (control group) | Post treatment: improvement of clinical symptoms: 64% in group CBT, 55% in individual CBT, 10% in control group. |
| Heymann-Mönnikes et al. (2000) The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. Am J Gastroenterol. (34) | 21 (87.5% female) | IBS symptoms Well-being Quality of life |
10 weeks: 1x1 h session multicomponent behavioral therapy/ week + medication vs. control group: medication only | Improvement in the behavioral therapy group (well-being, quality of life, symptoms; no change in the control group). |
| Boyce et al. (2003) A randomized controlled trial of cognitive behavior therapy, relaxation training, and routine clinical care for the irritable bowel syndrome. Am J Gastroenterol. (41) | 105 (81% female) | General health Pain Physical functioning Anxiety Depression |
8 weeks: 1x 1 h CBT/week vs. 8 weeks: 1x 30 min relaxation therapy/week | Reduction in anxiety, depression, improvement of general health, pain and physical functioning, no difference between groups. |
| Drossman et al. (2003) Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders. Gastroenterology. (42) | 169 (100% female) | Clinical, physiological, and psychosocial assessment | 12 weeks: 1x 1 h CBT/week vs. control group (education) | CBT was more beneficial over Education for all parameters except for depressiveness. |
| Tkachuk et al. (2003) Randomized controlled trial of cognitive-behavioral group therapy for irritable bowel syndrome in a medical setting. J Clin Psychol Med Settings. (43) | 28 (96% female) | Global symptoms | 1 week: 2x 90 min group CBT intervention, 8 weeks: 1x 90 min group CBT intervention/week vs. home-based symptom monitoring | Better improvement in global symptoms, daily pain, psychological distress, and quality of life in CBT group. |
| Kennedy et al. (2003) Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial. BMJ. (29) | 149 (n.s.) | Work and social adjustment scale Symptom severity |
6 weeks: 1x 50 min CBT/week + mebeverine vs. control group (mebeverine only) | CBT showed better reduction of symptom severity, benefit on work, and social adjustment scale compared to control group; effects persisted after 6–12 months. |
| Lackner et al. (2008) Self-administered cognitive behavior therapy for moderate to severe irritable bowel syndrome: clinical efficacy, tolerability, feasibility. Clin Gastroenterol Hepatol. (44) | 75 (87% female) | IBS symptom severity Quality of life Global symptoms |
10 weeks: 1x 1 h CBT/week vs. 10 weeks: 1x 1 h CBT on four occasions vs. control group (waiting list) | Both CBT methods were superior to control group and induced adequate relief of global symptoms. |
| Ljótsson et al. (2010) Internet-delivered exposure and mindfulness based therapy for irritable bowel syndrome—a randomized controlled trial. Behav Res Ther. (35) | 85 (85% female) | IBS symptom severity Quality of life Anxiety Depression General functioning |
CBT via Internet vs. control group (online discussion forum) | CBT group: 42% decrease in IBS symptoms, control group: 12% increase in IBS symptoms. |
| Craske et al. (2011) A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations. Behav Res Ther. (45) | 110 (74% female) | Clinical symptoms | 10 sessions of CBT or stress reduction training or attention control | CBT was superior to stress reduction training and attention control with regards to several domains; no difference between stress reduction training and attention control. |
| Bonnert et al. (2017) Internet-delivered cognitive behavior therapy for adolescents with irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol. (37) | 101 (61% female) | Gastrointestinal symptoms Quality of life |
10 weeks internet CBT vs. control group (wait list) | Greater improvement of gastrointestinal symptoms and quality of life in CBT compared to control group. |
| Lackner et al. (2018) Improvement in gastrointestinal symptoms after cognitive behavior therapy for refractory irritable bowel syndrome. Gastroenterology. (46) | 436 (80% female) | Gastrointestinal symptoms | Standard CBT: 10 weeks: 1x 60 min/week or minimal therapist contact CBT: four sessions or education (four sessions) | Minimal contact CBT was more effective than education and as effective as standard CBT. |
| Everitt et al. (2019) Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess. (38) | 558 (76% female) | IBS severity score Work and social adjustment scale |
Telephone-delivered CBT: 9 weeks: 6x 1 h sessions + 2 x 1 h at months 4+8 vs. web-delivered CBT: 9 weeks: 3x 30 min telephone sessions + 2x 30 min at months 4+8 vs. treatment as usual | CBT increased capacity to cope with symptoms and negative emotions; both CBT arms induced improvement in IBS severity score at 3, 6, 12 months compared to TAU. |
| Zhao et al. (2019) Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients. World J Clin Cases. (47) | 57 (75% female) | Cognitive bias Coping styles |
CBT + exercise vs. control group (drug therapy) | Greater improvement of cognitive bias and coping styles in CBT + exercise compared to control group. |
CBT, cognitive behavioral therapy; GI, gastrointestinal; IBS, irritable bowel syndrome; n.s., not specified; TAU, treatment as usual; RCT, randomized controlled trial.