Self-help Cognitive Behavioral Therapy Improves Health-Related Quality of Life for Inflammatory Bowel Disease Patients:
- PDF / 659,209 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 107 Downloads / 212 Views
Self‑help Cognitive Behavioral Therapy Improves Health‑Related Quality of Life for Inflammatory Bowel Disease Patients: A Randomized Controlled Effectiveness Trial Melissa G. Hunt1 · Paddy Loftus1 · Michael Accardo1 · Mary Keenan1 · Lauren Cohen1 · Mark T. Osterman2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Patients with inflammatory bowel disease (IBD) often have poor health-related quality of life (HRQL) and are at risk for anxiety and depression. Cognitive behavioral therapy (CBT) can help patients with IBD cope with their disease. Unfortunately, barriers to care include expense and availability of qualified therapists. Stand-alone, self-help CBT could improve access to care. This study examined the effectiveness of a self-help CBT workbook for patients with IBD. A randomized controlled trial compared the CBT workbook to an active psychoeducational control workbook. A total of 140 participants enrolled. In both groups, scores improved on a range of measures, including catastrophizing, visceral sensitivity, and HRQL, although pre-post effect sizes were generally larger in the CBT group. Only participants in the CBT group experienced significant improvements in anxiety and depression. Improvements were generally maintained or consolidated at 3-month follow-up. Self-help CBT can be an effective and inexpensive way to improve HRQL for patients with IBD. Keywords Crohn’s disease · Ulcerative colitis · Inflammatory bowel disease · Cognitive-behavioral therapy · Self-help · Health-related quality of life
Introduction Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), significantly impairs an individual’s health-related quality of life (HRQL) (Zhou, Ren, Irvine, & Yang, 2010). Unlike functional GI disorders such as irritable bowel syndrome (IBS), IBDs are autoimmune disorders that can result in significant physical disability and even life-threatening emergencies (Burisch, Jess, Martinato, & Lakatos, 2013). Indeed, up to 80% of patients with Crohn’s disease will require corrective surgery at some point in their life (Sica & Biancone, 2013). In addition, individuals who have IBD are much more likely to suffer from anxiety and depression compared with the general population (Goodhand et al., 2012; Graff, Walker, & Bernstein, * Melissa G. Hunt [email protected] 1
Department of Psychology, University of Pennsylvania, 425 S. University Ave, Philadelphia, PA 19104‑6241, USA
Division of Gastroenterology, Penn Presbyterian Medical Center, Philadelphia, PA, USA
2
2009; Kovacs & Kovacs, 2007), with individuals with active disease being particularly at risk (Mikocka-Walus, Knowles, Keefer, & Graff, 2016). The existence of a comorbid psychological disorder further reduces HRQL in individuals with IBD regardless of the medical severity of their condition (Guthrie, 2002; Iglesias-Rey et al., 2014). The relationship between psychological distress and disease activity appears to be bidirectional. Psychological distress may be a response to diseas
Data Loading...
