Does psychological counseling alter the natural history of inflammatory bowel disease?

Abstract

IBD-focused counseling may improve not only psychological well-being, but also the course of IBD in individuals with psychosocial stress.

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

“…It is now increasingly accepted that stress, stressful life events and depression can precipitate relapse in IBD; 52 whether this is, in part at least, through non-adherence to maintenance treatment is untested. Further studies of the effects of psychotherapy and antidepressants on the disease course in both adherent and non-adherent patients with IBD are required, 53,54 and care needs to be taken to control for potentially Univariate analyses were used to identify factors that were associated with thiopurine non-adherence and to guide the order of entry into the multivariate model above. Age and age of diagnosis were not included because they were co-linear with age group.…”

"Role of Psychosocial Factors on the Course of Inflammatory Bowel Disease and Associated Psychotherapeutic Approaches. A Fresh Perspective and Review"

“…There are limitations to the extent to which conclusions can be drawn based on the reviewed studies. Many studies had small sample sizes, were not adequately powered, or were qualitative or retrospective in nature [47,66]. In addition, some studies lacked control groups, follow up measurements, or objective markers of inflammation [5].…”

“…[44,58]. Many of the above studies have found long lasting effects from brief therapeutic interventions which may contribute to reduced health care utilization and costs and decreased productivity loss in managing IBD, for example reduction of outpatient attendances, sick-leave and hospital days [6,20,31,47,51,55,58]. Yet, some have found only a short term benefit with a diminished positive effect of therapy over time [57,60].…”

“…IBD patients who received more than six 1 hour-counseling sessions that included both cognitive behavioral therapy and solution-focused therapy, had significantly fewer relapses the following year compared to the year before psychotherapy and compared to their matched controls [47]. The 24 IBD patients who underwent these counseling sessions also had fewer outpatient attendances and a reduction in steroid and other IBD medication usage the year following therapy compared to their matched controls.…”

“…The 24 IBD patients who underwent these counseling sessions also had fewer outpatient attendances and a reduction in steroid and other IBD medication usage the year following therapy compared to their matched controls. Thus counseling may not only affect the patient's quality of life but also the course of IBD [47].…”