Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study

Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, which severely impairs the quality of life of patients. Treatment of refractory IBS patients is needed, but it is not yet widely available. Therefore, we previously developed a Japanese version of cognitive behavioral therapy with interoceptive exposure (CBT-IE) involving 10 face-to-face sessions to treat refractory IBS patients. To disseminate this treatment of IBS in places where therapists are limited, we further developed a hybrid CBT-IE program with complementary video materials that include psychoeducation and homework instructions so that patients can prepare for face-to-face sessions in advance at home and the session time can be shortened, thereby reducing the burden on both patient and therapist. In this study, we conducted a trial to evaluate the feasibility, efficacy, and safety of the hybrid CBT-IE program for Japanese IBS patients. The study was a single-arm, open-label pilot clinical trial. A total of 16 IBS patients were included in the study and 14 patients completed the intervention, which consisted of 10 weekly individual hybrid CBT-IE sessions. We performed an intention to treat analysis. The primary outcome measure for the efficacy of the intervention was a decrease in the severity of IBS symptoms. The feasibility and safety of the intervention were examined by the dropout rate and recording of adverse events, respectively. The dropout rate of the hybrid CBT-IE was comparable to that of our previous CBT-IE with only face-to-face sessions and no adverse events were recorded. The severity of IBS symptoms within-group was significantly decreased from the baseline to mid-treatment [Hedges' g = −0.98 (−1.54, −0.41)], post-treatment [Hedges' g = −1.48 (−2.09, −0.88)], 3-month follow-up [Hedges' g = −1.78 (−2.41, −1.14)], and 6-month follow-up [Hedges' g = −1.76 (−2.39, −1.13)]. Our results suggest that the hybrid CBT-IE is effective and could be conducted safely. To confirm the effectiveness of the hybrid CBT-IE, it is necessary to conduct a multicenter, parallel-design randomized control trial.Clinical Trial Registration: [https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041376], identifier [UMIN000036327].

Clinical Efficacy of Cognitive Behavioral Therapy Combined with Pinaverium Bromide Tablets on Irritable Bowel Syndrome

“…23 Studies have shown that the visceral sensitivity, gastrointestinal symptoms and mental symptoms of patients treated with CBT are significantly improved. 24 The results of the present study showed that the SDS and SAS scores of the observation group and the control group decreased after treatment, and the scores of the observation group were significantly lower than those of the control group, which was consistent with the conclusions from previous studies. Pinaverium bromide monotherapy improved the severity of IBS symptoms to a certain extent, and the mental and psychological symptoms, IBS symptom severity and quality of life, however, were significantly improved when these IBS patients were treated with…”

“… 23 Studies have shown that the visceral sensitivity, gastrointestinal symptoms and mental symptoms of patients treated with CBT are significantly improved. 24 …”

Remote psychological assistance for chronic visceral pain associated with irritable bowel syndrome.

“…Более того, тот факт, что основные механизмы КПТ остаются плохо изученными, продолжает препятствовать использованию КПТ для лечения висцеральной боли. С акцентом на улучшение доступа к психологической терапии с помощью удаленного доступа к КПТ, показано, что дистанционные протоколы (Minimal-Contact CBT IBS) также эффективны для уменьшения симптомов СРК по сравнению с обычным лечением, направленным только на психообразование [14]. В связи с этим целью данной статьи является знакомство врачей-гастроэнтерологов и специалистов в области психического здоровья с современными дистанционными протоколами когнитивно-поведенческой терапии «третьей» волны хронической висцеральной боли для привлечения специ-ально обученных клинических психологов в системную тактику лечения пациентов с рефрактерным синдромом раздраженного кишечника.…”

Editorial: Resilience in chronic disease, volume II

“…Resilience, defined as one's ability to “bounce back” from adversity, is an important attribute of patients challenged with chronic disease ( 1 , 2 ). The call for submissions on Resilience in Chronic Disease: Volume I received a great response with a total of over 7,100 participants with chronic pain ( 3 ), cancer ( 4 ), irritable bowel disease ( 5 , 6 ), cardiovascular disease ( 7 ), neurocognitive disorders ( Wang et al ), renal transplant ( 8 ), rheumatoid arthritis ( 9 ), as well as caregivers for children with chronic illness ( 7 ), patients with liver cancer ( 10 ), and maintenance hemodialysis ( 7 ). However, most manuscript are performed with a cross-sectional design and the distinct resilience trajectories throughout the course of chronic disease are not well-explored in the first collection ( 11 ).…”