title: Mindfulness-based therapy for inflammatory bowel disease patients with functional abdominal symptoms or high perceived stress levels.
abstract: OBJECTIVE
  Psychological interventions are used in patients with inflammatory bowel disease (IBD) but there is uncertainty about who the optimal target population is. Multi-convergent therapy (MCT) is a form of psychotherapy that combines mindfulness meditation with aspects of cognitive behavioural therapy and has been used in the management of irritable bowel syndrome (IBS). This study aimed to assess the feasibility and efficacy of MCT in the management of IBD patients with either functional abdominal symptoms or high perceived stress levels.
  
  
  METHODS
  Sixty-six IBD patients in clinical remission with either IBS-type symptoms or high perceived stress levels were randomly allocated to a 16-week MCT course or waiting list control group. Patients were followed-up for one year with the Inflammatory Bowel Disease Questionnaire (IBDQ) as the primary outcome measurement.
  
  
  RESULTS
  A higher mean IBDQ score was observed in the active group compared to controls at the 4-month assessment (167 vs. 156, p=0.081), but this was not statistically significant nor did it reached the predefined clinically significant difference of 20. In patients with IBS-type symptoms at baseline there was a significantly higher mean IBDQ score in the active group compared to controls (161 vs. 145, p=0.021). There was no difference between groups in relapse rate based on faecal calprotectin measurement.
  
  
  CONCLUSIONS
  IBS-type symptoms in patients with IBD represent a potential therapeutic target to improve quality of life. This study suggests that MCT may be useful in the management of these symptoms but larger studies are required to confirm this.
  
  
  BACKGROUND
  NCT01426568.
authors: Department of Gastroenterology, University Hospital Llandough, Cardiff, UK. Electronic address: jamesberrill1@doctors.org.uk.
authors: James W
authors: JW
authors: Berrill
authors: Department of Physiotherapy, University Hospital of Wales, Cardiff, UK.
authors: Mike
authors: M
authors: Sadlier
authors: South East Wales Trials Unit, Cardiff University, Cardiff, UK.
authors: Kerenza
authors: K
authors: Hood
authors: Department of Gastroenterology, University Hospital Llandough, Cardiff, UK.
authors: John T
authors: JT
authors: Green
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Inflammatory bowel disease; Irritable bowel syndrome; Mindfulness; Psychotherapy