Reducing psychological distress in patients with inflammatory bowel disease by cognitive-behavioural treatment: exploratory study of effectiveness

• Published in: Scandinavian journal of gastroenterology Vol. 38; no. 7; p. 755
• Main Authors: Mussell, M, Böcker, U, Nagel, N, Olbrich, R, Singer, M V
• Format: Journal Article
• Language: English
• Published: England 01.07.2003
• Subjects: Adaptation, Psychological; Adult; Cognitive Behavioral Therapy; Colitis, Ulcerative - psychology; Colitis, Ulcerative - therapy; Crohn Disease - psychology; Crohn Disease - therapy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Program Evaluation; Prospective Studies; Psychotherapy, Group; Severity of Illness Index; Stress, Psychological - etiology; Stress, Psychological - prevention & control; Stress, Psychological - psychology; Time Factors; Treatment Outcome
• ISSN: 0036-5521
• DOI: 10.1080/00365520310003110

This prospective study aimed to determine whether cognitive-behavioural group treatment accompanying medical standard care is effective in reducing psychological distress in patients with inflammatory bowel disease. Twenty-eight outpatients with Crohn disease or ulcerative colitis completed the treatment programme. Psychological treatment consisting of 12 weekly sessions was conducted in a group setting. Medical and psychometric assessments were taken at the beginning of the 3-month pretreatment waiting period, at pretreatment, at post-treatment and at the 3, 6 and 9-month follow-ups. During baseline, no change was observed in psychological distress. Disease-related worries and concerns decreased significantly from pretreatment to the follow-ups. The disease groups differed in the decline of concerns between pre- and post-treatment, with a significant reduction of concerns in patients with ulcerative colitis but not Crohn disease. This difference did not occur at the follow-ups, indicating long-term improvement for both disease groups. Depressive coping decreased significantly in women and remained stable at the follow-ups, whereas depressive coping did not change in men. The same gender difference was found for depressive symptoms. The exploratory findings suggest that psychological group treatment for outpatients is a feasible and effective approach for the short- and long-term reduction of psychological distress for patients with inflammatory bowel disease. However, the revealed gender differences on coping and depression might indicate the necessity to consider gender-specific aspects of inflammatory bowel disease when designing and evaluating psychological interventions.