title: The therapeutic effect of adding emotional awareness training to standard medical treatment for irritable bowel syndrome: a randomized clinical trial.
abstract: OBJECTIVE
  This randomized trial evaluated the therapeutic effect of emotional awareness training on the severity and frequency of pain in patients with irritable bowel syndrome (IBS). Patients' level of alexithymia was also measured.
  
  
  METHODS
  The study involved 100 patients diagnosed with IBS according to the Rome-III criteria. Patients' mean age was 34.98 years (standard deviation 10.22 years) and 60% of the patients were female. Seventy eligible patients were assigned randomly to one of two treatment groups. One group received standard symptom-oriented medical treatment only (MT group), while the second group, termed the emotional awareness group (EMT), was educated to increase conscious awareness of eight primary emotions in addition to receiving standard symptom-oriented medical treatment. This study was conducted over 20 months. All patients received 5 weeks of symptom-oriented medical treatment; patients in the EMT group also had two emotion awareness training sessions and recorded their emotions in a daily diary. Sixty patients completed the study.
  
  
  RESULTS
  Patients with IBS scored significantly higher on all aspects of alexithymia compared with healthy controls. The severity of pain decreased significantly in both groups, with a larger percentage of the patients in the EMT group who completed the study having a significant decrease in pain (54% in the EMT group vs. 36% in the MT group); this finding was replicated in an intent-to-treat analysis. The same results were observed for frequency of pain in patients who completed the study (59% in the EMT group vs 43.4% in the MT group), but this finding was not replicated in an intent-to-treat analysis. These patterns were not influenced by level of alexithymia, age, or gender.
  
  
  CONCLUSIONS
  Adding emotional awareness training to medical treatment resulted in a better therapeutic response in abdominal pain in patients with IBS.
authors.affiliation: FARNAM, FARHANG, and MAHDAVI: Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran; SOMI: Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences; BESHARAT: Department of Psychology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Farnam
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Somi
authors.forename: Sara
authors.initials: S
authors.lastname: Farhang
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Mahdavi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ali Besharat
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology / Q000628:therapy*; D001364:Awareness / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000628:therapy*; D008297:Male; D010146:Pain / Q000209:etiology / Q000534:rehabilitation*; D010147:Pain Measurement; D012042:Registries; D012720:Severity of Illness Index; D016896:Treatment Outcome