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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Mussell
M
M
Dept. of Medicine II (Gastroenterology/Hepatology/Infectious Diseases), University of Heidelberg, Medical Faculty of Mannheim, Mannheim, Germany.
Böcker
U
U
Nagel
N
N
Olbrich
R
R
Singer
M V
MV
D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003093:Colitis, Ulcerative / Q000523:psychology* / Q000628:therapy; D003424:Crohn Disease / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D011615:Psychotherapy, Group; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome