title: The potential role of a self-management intervention for ulcerative colitis: a brief report from the ulcerative colitis hypnotherapy trial.
abstract: Inflammatory bowel diseases (IBD) are chronic inflammatory illnesses marked by unpredictable disease flares, which occur spontaneously and/or in response to external triggers, especially personal health behaviors. Behavioral triggers of flare may be responsive to disease self-management programs. We report on interim findings of a randomized controlled trial of gut-directed hypnotherapy (HYP, n = 19) versus active attention control (CON, n = 17) for quiescent ulcerative colitis (UC). To date, 43 participants have enrolled; after 5 discontinuations (1 in HYP) and 2 exclusions due to excessive missing data, 36 were included in this preliminary analysis. Aim 1 was to determine the feasibility and acceptability of HYP in UC. This was achieved, demonstrated by a reasonable recruitment rate at our outpatient tertiary care clinic (20%), high retention rate (88% total), and our representative IBD sample, which is reflected by an equal distribution of gender, an age range between 21 and 69, recruitment of ethnic minorities (∽20%), and disease duration ranging from 1.5 to 35 years. Aim 2 was to estimate effect sizes on key clinical outcomes for use in future trials. Effect sizes (group × time at 20 weeks) were small to medium for IBD self-efficacy (.34), Inflammatory Bowel Disease Questionnaire (IBDQ) total score (.41), IBDQ bowel (.50), and systemic health (.48). Between-group effects were observed for the IBDQ bowel health subscale (HYP > CON; p = .05) at 20 weeks and the Short Form 12 Health Survey Version 2 (SF-12v2) physical component (HYP > CON; p < .05) at posttreatment and 20 weeks. This study supports future clinical trials testing gut-directed HYP as a relapse prevention tool for IBD.
authors.affiliation: Center for Psychosocial Research in GI, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. laurie.keefer@northwestern.edu
authors.forename: Laurie
authors.initials: L
authors.lastname: Keefer
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Kiebles
authors.forename: Monika A
authors.initials: MA
authors.lastname: Kwiatek
authors.forename: Olafur
authors.initials: O
authors.lastname: Palsson
authors.forename: Tiffany H
authors.initials: TH
authors.lastname: Taft
authors.forename: Zoran
authors.initials: Z
authors.lastname: Martinovich
authors.forename: Terrence A
authors.initials: TA
authors.lastname: Barrett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D006990:Hypnosis; D008297:Male; D008875:Middle Aged; D012648:Self Care; D055815:Young Adult