title: Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis.
abstract: BACKGROUND
  Psychotherapy is not routinely recommended for in ulcerative colitis (UC). Gut-directed hypnotherapy (HYP) has been linked to improved function in the gastrointestinal tract and may operate through immune-mediated pathways in chronic diseases.
  
  
  OBJECTIVE
  To determine the feasibility and acceptability of HYP and estimate the impact of HYP on clinical remission status over a 1-year period in patients with an historical flare rate of 1.3 times per year.
  
  
  METHODS
  A total of 54 patients were randomised at a single site to seven sessions of gut-directed HYP (n = 26) or attention control (CON; n = 29) and followed for 1 year. The primary outcome was the proportion of participants in each condition that had remained clinically asymptomatic (clinical remission) through 52 weeks post treatment.
  
  
  RESULTS
  One-way analysis of variance comparing HYP and CON subjects on number of days to clinical relapse favoured the HYP condition [F = 4.8 (1, 48), P = 0.03] by 78 days. Chi-squared analysis comparing the groups on proportion maintaining remission at 1 year was also significant [χ²(1) = 3.9, P = 0.04], with 68% of HYP and 40% of CON patients maintaining remission for 1 year. There were no significant differences between groups over time in quality of life, medication adherence, perceived stress or psychological factors.
  
  
  CONCLUSIONS
  This is the first prospective study that has demonstrated a significant effect of a psychological intervention on prolonging clinical remission in patients with quiescent ulcerative colitis (Clinical Trial # NCT00798642).
authors: Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. laurie.keefer@northwestern.edu
authors: L
authors: L
authors: Keefer
authors: T H
authors: TH
authors: Taft
authors: J L
authors: JL
authors: Kiebles
authors: Z
authors: Z
authors: Martinovich
authors: T A
authors: TA
authors: Barrett
authors: O S
authors: OS
authors: Palsson
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction / Q000379:methods; D016896:Treatment Outcome
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