The Effect of Psychotherapy on Quality of Life in IBD Patients: A Systematic Review

Abstract

Background Patients with inflammatory bowel disease (IBD) express a need for additional psychotherapy; however, psychological support is not incorporated in the routine care of persons with IBD. This systematic review aims to assess the effect of psychotherapy on quality of life (QoL). Methods A systematic search was conducted on October 7, 2019, using Embase, Medline (Ovid), PubMed, Cochrane, Web of Science, PsycInfo, and Google Scholar to collect all types of clinical trials with psychotherapeutic interventions that measured QoL in patients with IBD aged ≥18 years. Quality of evidence was systematically assessed using the Grading of Recommendations Assessment, Development, and Evaluation criteria. Results Out of 2560 articles, 31 studies (32 articles) were included with a total number of 2397 patients with active and inactive IBD. Of the 31 eligible studies, 11 reported a significant positive effect and 6 had ambiguous results regarding the impact of psychotherapeutic interventions on QoL. Treatment modalities differed in the reported studies and consisted of cognitive-behavioral therapy, psychodynamic therapy, acceptance and commitment therapy, stress management programs, mindfulness, hypnosis, or solution-focused therapy. All 4 studies focusing on patients with active disease reported a positive effect of psychotherapy. Trials applying cognitive-behavioral therapy reported the most consistent positive results. Conclusions Psychotherapeutic interventions can improve QoL in patients with IBD. More high-quality research is needed before psychological therapy may be implemented in daily IBD practice and to evaluate whether early psychological intervention after diagnosis will result in better coping strategies and QoL throughout life.

The clinical value of psycho‐gastroenterological interventions for functional esophageal symptoms

“…At our center, psycho‐gastroenterological multimodal therapy was administered by a health psychologist trained in psycho‐gastroenterology practice, who was not involved in initial or follow‐up patient evaluations. This model has been utilized in other centers to provide cognitive and behavioral therapy, gut directed hypnotherapy, biofeedback, and diaphragmatic breathing to patients with DGBI, 5,6,20,21 and non‐DGBI gastrointestinal disorders such as inflammatory bowel disease 22,23 . Although related to psychotherapy for affective disorders, this psycho‐gastroenterology skill set is specifically adapted for management of individuals with DGBI and includes techniques to reduce hypervigilance, symptom‐related anxiety, autonomic nervous system arousal, and catastrophizing while improving coping and day‐to‐day function 20,24 .…”

“…This model has been utilized in other centers to provide cognitive and behavioral therapy, gut directed hypnotherapy, biofeedback, and diaphragmatic breathing to patients with DGBI, 5,6,20,21 and non-DGBI gastrointestinal disorders such as inflammatory bowel disease. 22,23…”

Diagnosis and Psychotherapeutic Needs by Early Maladaptive Schemas in Patients With Inflammatory Bowel Disease

“…In a 2019 literature review Paulides et al (2021) concluded that psychotherapy can improve the quality of life of IBD patients. They further stated that additional studies are needed to introduce psychological intervention immediately after diagnosis so that the patient learns good constructive coping strategies throughout life.…”

Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse

“…IBD affects interpersonal relationships, life activities, social participation, and mental well-being [ 8 , 9 , 10 ]. Psychological support does not belong to the standard care of patients with IBD although it is suggested that psychotherapeutic interventions can improve the quality of life of individuals with IBD [ 11 ]. Furthermore, IBD may compromise patients’ workability and impact other parameters of work impairment, such as absenteeism, presenteeism, activity, and productivity loss [ 12 ].…”