A randomized controlled trial of psychotherapy in patients with chronic functional dyspepsia

Hamilton, Jane; Guthrie, Elspeth; Creed, Francis; Thompson, David G.; Tomenson, Barbara; Bennett, R. J. M.; Moriarty, Kieran; Stephens, William J.; Liston, Richard

doi:10.1053/gast.2000.16493

Cited by 177 publications

(126 citation statements)

References 19 publications

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“…5,10,11 In addition, dyspeptic patients score higher than controls in terms of anxiety, depression and neuroticism, suggesting that psychological factors may aggravate symptoms and that there may be a therapeutic role for psychological intervention. [13][14][15] Better established is the efficacy of treatment with gastrokinetic drugs. 9 Cisapride has been shown to accelerate gastric emptying and improve symptoms in functional dyspepsia.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Patients with functional dyspepsia report higher rates of anxiety and depression and higher levels of exposure to chronic social stressors than other functional gut syndromes. 13,14 Encouraging results have been obtained by psychodynamic psychotherapy, 15 but this is a complex treatment requiring referral to a dedicated psychotherapist and may not be accepted by the patient. Hypnosis is a well known relaxation and stress management technique that has been used by gastroenterologists to treat irritable bowel syndrome and to decrease peptic ulcer relapse.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prokinetic effect of gut‐oriented hypnosis on gastric emptying

Chiarioni

Vantini

Iorio

et al. 2006

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prokinetic effect of gut‐oriented hypnosis on gastric emptying

Chiarioni

Vantini

Iorio

et al. 2006

Aliment Pharmacol Ther

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“…Psychotherapy. In contrast to IBS, psychotherapy has rarely been tested in functional dyspepsia and has not been shown to be effective: only four controlled trials [210][211][212][213] were published until 2002 and an updated 2011 Cochrane analysis was withdrawn for unknown reasons. Three additional trials [214][215][216] were performed since the first Cochrane review, and all seven trials together covered the entire spectrum of psychotherapy options, but each technique was tested only in a single, small study (TABLE 2).…”

Section: Pharmacological Treatment Of Epsmentioning

confidence: 99%

“…Greater reduction of dyspeptic symptoms, nausea, heartburn, diarrhoea and constipation and better scores on 'target complaints' (defined by the patients themselves, for example, anxiety, life stress or interpersonal problems) in the treatment arm compared with the control arm Psychodynamic interpersonal psychotherapy (Hamilton et al 212 )…”

Section: Quality Of Lifementioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

261

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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“…In the case of nine papers (Cooper, Murray, Wilson, & Romaniuk, 2003;de Jonghe et al, 2004;Hamilton et al, 2000;Linnet and Jemec, 2001;Maina et al, 2005;Monsen & Monsen, 2000;Shapiro et al, 1994/Hardy et al, 1995Svartberg, Stiles, & Seltzer, 2004;Winston et al, 1994), ratings were completed by two coders because of overlap of studies in the authors' respective databases. Interrater reliability was computed for categorical data with the kappa coefficient, and all values (range ϭ 0.84 to 1.0) were in the excellent range (Ͼ0.74; Fleiss, 1981).…”

Section: Data Extractionmentioning

confidence: 99%

A meta-analysis of psychodynamic psychotherapy outcomes: Evaluating the effects of research-specific procedures.

et al. 2012

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The aim of this research was to examine the extent to which the use of research-specific procedures in psychodynamic psychotherapy impacts upon treatment effectiveness and which variables moderate this potential relationship. Effects of audio/video recording of sessions, use of treatment manuals, and checks of treatment fidelity were examined. A meta-analysis was conducted on randomized controlled trials of psychodynamic psychotherapy. Forty-six independent treatment samples totaling 1615 patients were included. The magnitude of change between pretreatment and posttreatment aggregated across all studies (45 treatment samples) for overall outcome was large (d ϭ 1.01), and further improvement was observed between posttreatment and an average 12.8-month follow-up (d ϭ 0.18). Subgroup analyses comparing studies that used research-specific procedures and those that did not revealed that for posttreatment data no differences in treatment effects were found. However, the use of treatment manuals and fidelity checks were significantly associated with improvement between the end of treatment and follow-up assessment. Within the limitations of analyses, this data offered preliminary evidence that use of research-specific procedures does not contribute in a negative manner to posttreatment outcomes in psychodynamic psychotherapy, and their use contributes to positive differences that emerge with time. These findings, although observational in nature, make a case for reconsidering how dimensions of clinical utility and experimental control may be integrated in psychodynamic psychotherapy to enable further elucidation of principles that evidently work.

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A randomized controlled trial of psychotherapy in patients with chronic functional dyspepsia

Cited by 177 publications

References 19 publications

Prokinetic effect of gut‐oriented hypnosis on gastric emptying

Prokinetic effect of gut‐oriented hypnosis on gastric emptying

Functional dyspepsia

A meta-analysis of psychodynamic psychotherapy outcomes: Evaluating the effects of research-specific procedures.

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