Predictors of treatment outcome after cognitive behavior therapy and antispasmodic treatment for patients with irritable bowel syndrome in primary care
Abstract
Objective To examine predictors of treatment outcome in IBS-patients who participated in a randomized controlled trial in primary care, where 149 irritable bowel syndrome (IBS) patients were randomized to mebeverine hydrochloride (n=77) or mebeverine+cognitive behavior therapy (CBT) (n=72). CBT offered additional benefit over mebeverine alone.Methods Regression analyses were used to identify predictors of work and social adjustment 12 months after treatment ended. The intervention groups were analyzed separately in order to look at the separate effects in each group.Results Lower levels of psychological distress (anxiety and depression) at baseline predicted a good outcome in the mebeverine group [beta=0.388 (95% CI: 0.065-0.936), P=.025] but not in the mebeverine+CBT group. In the adjusted model for the mebeverine+CBT group less adaptive IBS related behavioral coping predicted a good outcome [beta=0.285 (95% CI: 0.002-0.210), P=.045].Conclusion Different factors are associated with outcome depending on the treatment received. At assessment clinicians should assess patients coping styles and may want to consider recommending CBT to those patients with IBS in primary care who are engaging in unhelpful coping behavior.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The text we found for this paper looks like another document, so the self-check wasn’t run.
Cites
Tabachnick, B. G., & Fidell, L. S. (1983) · Cited by 79,888 · see citing works
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
The Work and Social Adjustment Scale: a simple measure of impairment in functioning
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.180.5.461 · Cited by 2,515 · see citing works
FRANCIS, C. Y., MORRIS, J., & WHORWELL, P. J. (1997) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.1997.142318000.x · Cited by 1,708 · see citing works
Weinman, J. A., Petrie, K. J., Moss-Morris, R. E., & Horne, R. (1996) · Psychology and Health · doi:10.1080/08870449608400270 · Cited by 1,557 · see citing works
Drossman, D. A., Toner, B. B., Whitehead, W. E., Diamant, N. E., Dalton, C. B., Duncan, S., Emmott, S., Proffitt, V., Akman, D., Frusciante, K., et al. (2003) · Gastroenterology · doi:10.1016/s0016-5085(03)00669-3 · Cited by 614 · cited 2× · see citing works
“Less baseline anxiety predicted a better outcome in one study [1], whereas others have found a lower likelihood of success with the presence of one or more psychiatric disorders [2,3] and baseline depression [4].”
BackgroundResultDeary, V., Chalder, T., & Sharpe, M. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.07.002 · Cited by 480 · see citing works
Self-citationA controlled trial of psychological treatment for the irritable bowel syndrome
Guthrie, E., Creed, F. H., Dawson, D., & Tomenson, B. (1991) · Gastroenterology · doi:10.1016/0016-5085(91)90215-7 · Cited by 461 · see citing works
Kennedy, T., Jones, R. H., Darnley, S., Seed, P. T., Wessely, S. C., & Chalder, T. (2005) · BMJ · doi:10.1136/bmj.38545.505764.06 · Cited by 190 · see citing works
Self-citationLackner, J. M., Jaccard, J., Krasner, S. S., Katz, L. A., Gudleski, G. D., & Blanchard, E. B. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.05.014 · Cited by 172 · see citing works
Cognitive-Behavioral Group Therapy for Patients with Irritable Bowel Syndrome
Toner, B. B., Segal, Z. V., Emmott, S., Myran, D. D., Ali, A., Gasbarro, I. D., & Stuckless, N. (1998) · International Journal of Group Psychotherapy · doi:10.1080/00207284.1998.11491537 · Cited by 91 · see citing works
The development of the irritable bowel syndrome-behavioral responses questionnaire
Reme, S. E., Darnley, S., Kennedy, T., & Chalder, T. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.01.025 · Cited by 64 · see citing works
Self-citationCreed, F. H., Guthrie, E., Ratcliffe, J., Fernandes, L., Rigby, C., Tomenson, B., Read, N., & Thompson, D. G. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01686.x · Cited by 63 · see citing works
Dowell, A. C., & Biran, L. A. (1990) · PubMed · Cited by 48 · see citing works
Blanchard, E. B., Lackner, J. M., Gusmano, R., Gudleski, G. D., Sanders, K. A., Keefer, L., & Krasner, S. S. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.01.003 · Cited by 47 · see citing works
Prediction of outcome from cognitive-behavioral treatment of irritable bowel syndrome
Blanchard, E. B., Scharff, L., Payne, A., Schwarz, S. P., Suls, J. M., & Malamood, H. S. (1992) · Behaviour Research and Therapy · doi:10.1016/0005-7967(92)90011-5 · Cited by 45 · see citing works
Prediction of outcome from the self-regulatory treatment of irritable bowel syndrome
Blanchard, E. B., Schwarz, S. P., Neff, D. F., & Gerardi, M. A. (1988) · Behaviour Research and Therapy · doi:10.1016/0005-7967(88)90119-2 · Cited by 37 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Irritable bowel syndrome: A clinical review
Soares, R. L. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i34.12144 · Cited by 266 · see citing works
Ljótsson, B., Andersson, G., Andersson, E., Hedman, E., Lindfors, P., Andréewitch, S., Rück, C., & Lindefors, N. (2011) · BMC Gastroenterology · doi:10.1186/1471-230x-11-110 · Cited by 132 · see citing works
“Indeed, a recent study showed that improvement after CBT for IBS was mediated through change in avoidance behaviors and negative thoughts about symptoms [58] and that less adaptive IBS behaviors predicted good outcome [59].”
BackgroundFerreira, N. B., Gillanders, D., Morris, P. G., & Eugenicos, M. (2018) · Clinical Psychologist · doi:10.1111/cp.12123 · Cited by 44 · see citing works
Denial Predicts Outcome in Anxiety Following Group Cognitive Behavioral Therapy.
Oei, T.-P. S., Strodl, E., Pang, J., & Cui, L. (2013) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.27.4.370 · Cited by 4 · see citing works
Manesh, F., Aghalar, S., Khorami, N., & Hafezi, F. (2020) · International Archives of Health Sciences · doi:10.4103/iahs.iahs_80_19 · Cited by 1 · see citing works
- Authors
- Reme, S. E., Kennedy, T., Jones, R., Darnley, S., & Chalder, T.
- Affiliations
- King's College London (GB)
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2010-04
- Volume
- 68
- Issue
- 4
- Pages
- 385-388
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2018061064
- Cited by
- 31
- References
- 17
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2020: 2 · 2018: 2 · 2017: 3 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 2
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- irritable bowel syndrome, cognitive behavioral therapy, mebeverine, antispasmodic therapy, predictors of treatment outcome, psychological distress, anxiety, depression, coping styles, work and social adjustment, primary care
- MeSH terms
- Adolescent, Adult, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Parasympatholytics, Phenethylamines, Primary Health Care, Prospective Studies, Cognitive Behavioral Therapy, Treatment Outcome, Irritable Bowel Syndrome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
