title: Cognitive-Behavioural Therapy for Inflammatory Bowel Disease: 24-Month Data from a Randomised Controlled Trial.
abstract: There is ongoing controversy on the effectiveness of psychotherapy in inflammatory bowel disease (IBD). In the few small studies, cognitive-behavioural therapy (CBT) has been shown to alleviate symptoms of anxiety or depression. However, there is little research on the impact of CBT on physical outcomes in IBD and no studies on long-term effectiveness of CBT.
  
  
  
  The present two-arm pragmatic randomised controlled trial aimed to establish the impact of CBT on disease course after 24 months of observation. The study compared standard care plus CBT (+CBT) with standard care alone (SC). CBT was delivered over 10 weeks, face-to-face (F2F) or online (cCBT). The data were analysed using linear mixed-effects models.
  
  
  
  CBT did not significantly influence disease activity as measured by disease activity indices at 24 months (Crohn's Disease Activity Index (CDAI), p = 0.92; Simple Clinical Colitis Activity Index (SCCAI), p = 0.88) or blood parameters (C-reactive protein (CRP), p < 0.62; haemoglobin (Hb), p = 0.77; platelet, p = 0.64; white cell count (WCC), p = 0.59) nor did CBT significantly affect mental health, coping or quality of life (all p > 0.05).
  
  
  
  Therefore, we conclude that CBT does not influence the course of IBD over 24 months. Given the high rate of attrition, particularly in the CBT group, future trials should consider a personalised approach to psychotherapy, perhaps combining online and one-to-one therapist time.
authors.affiliation: School of Nursing and Midwifery and Sansom Institute for Health Research, University of South Australia, Adelaide, 5001, Australia. Antonina.mikocka-walus@york.ac.uk.|Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK. Antonina.mikocka-walus@york.ac.uk.|School of Psychology, University of Adelaide, Adelaide, 5005, Australia. Antonina.mikocka-walus@york.ac.uk.
authors.forename: Antonina
authors.identifier: 0000-0003-4864-3956
authors.initials: A
authors.lastname: Mikocka-Walus
authors.affiliation: School of Medicine, Flinders University, Bedford Park, 5042, Australia.|Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, 5042, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Bampton
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, 5001, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Hetzel
authors.affiliation: Centre for Nutrition and Gastrointestinal Diseases, School of Medicine, University of Adelaide, Adelaide, 5001, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hughes
authors.affiliation: School of Nursing and Midwifery and Sansom Institute for Health Research, University of South Australia, Adelaide, 5001, Australia.|Australian Institute for Health and Tropical Medicine, James Cook University, Smithfield, 4878, Australia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Esterman
authors.affiliation: School of Medicine, Flinders University, Bedford Park, 5042, Australia.|Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, 5001, Australia.|Centre for Nutrition and Gastrointestinal Diseases, School of Medicine, University of Adelaide, Adelaide, 5001, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Andrews
mesh_terms: D001007:Anxiety / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology / Q000628:therapy*; D008603:Mental Health; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life
keywords: Cognitive-behavioural therapy; Disease course; Inflammatory bowel disease