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Psychological treatments for irritable bowel syndrome: a systematic review and meta-analysis
Abstract
This study conducted a systematic review to assess the quality of existing literature on psychological treatments for irritable bowel syndrome and to quantify the evidence for their efficacy. Three independent reviewers (2 from England, 1 from the United States) coded the quality of 32 studies, 17 of which provided data suitable for meta-analysis. Meta-analysis of efficacy data (50% reduction of symptoms) gave an odds ratio of 12 (95% confidence interval = 5.56-25.96) and a number needed to treat of 2. Psychological treatments are, as a class of interventions, effective in reducing symptoms compared with a pooled group of control conditions. Questions regarding the relative superiority of specific psychological treatments and influence of active versus nonspecific treatment effects remain unanswered.
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“The average effect on GI symptoms after treatment (d ¼ 0.69) in our analysis was similar to that reported previously for bowel dysfunction (d ¼ 0.57) and considerably higher than that reported previously for abdominal pain (d ¼ 0.27) in the only previously published meta-analysis on this topic using continuous outcomes.7”
From Short-term and long-term efficacy of psychological therapies for irritable bowel syndrome: a systematic review and meta-analysis (2016) · cites this paper as [7]
In the citing paper
“Meta-analyses suggest that psychological therapies are as effective as antidepressants in reducing GI symptoms in IBS immediately after treatment, with a number needed to treat between 2 and 4. [5][6][7]”
From Short-term and long-term efficacy of psychological therapies for irritable bowel syndrome: a systematic review and meta-analysis (2016) · cites this paper as [7]
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“A 29-item version of the Cochrane Collaboration Depression Anxiety, and Neurosis Review Group (CCDAN) scale (52), as adapted by Lackner et al (53) to suit the evaluation of psychological trials, was used to assess the quality of the included studies.”
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“From these conclusions, the National Institute for Health and Clinical Excellence guidelines noted that hypnotherapy is a promising intervention for IBS but the evidence remains to be limited.19 These uncertainties justify a systematic review and meta-analysis to determine whether hypnotherapy has significant benefici…”
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“For example, a recent meta-analysis of controlled trials of psychologic treatments for IBS (6,34) concluded that psychologic treatments for IBS as a class are effective and seem to be as effective for changing bowel symptoms as for changing mood.”
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“In conclusion, meaningful differences were identified between the IBS and control group on a number of environmental, cognitive, and psychological distress factors, further supporting the role of psychosocial factors in IBS [11].”
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“Overall, the efficacy of psychological intervention remains unclear [”
BackgroundExpressive Writing Is a Promising Therapeutic Modality for the Management of IBS: A Pilot Study
Halpert, A. D., Rybin, D. V., & Doros, G. D. (2010) · The American Journal of Gastroenterology · doi:10.1038/ajg.2010.246 · Cited by 58
Mind-body treatments of irritable bowel syndrome symptoms: An updated meta-analysis
Shah, K., Ramos-Garcia, M., Bhavsar, J., & Lehrer, P. M. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.103462 · Cited by 58
Müller, A., Franke, H., Resch, K.-L., & Fryer, G. (2014) · Journal of Osteopathic Medicine · doi:10.7556/jaoa.2014.098 · Cited by 88
Blackmore, C., Tantam, D., Parry, G. D., & Chambers, E. (2012) · Group Analysis · doi:10.1177/0533316411424356 · Cited by 56
“double blinding) were inappropriate (Lackner et al., 2004).”
MethodTreatment of abdominal pain in irritable bowel syndrome
Vanuytsel, T., Tack, J., & Boeckxstaens, G. (2014) · Journal of gastroenterology · doi:10.1007/s00535-014-0966-7 · Cited by 49
“CBT has been demonstrated to reduce IBS-related symptoms in several well-performed trials [35, 36] and meta-analyses [37, 38].”
BackgroundMarques, M. M., De Gucht, V., Gouveia, M. J., Leal, I., & Maes, S. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.05.009 · Cited by 50
“…trials was assessed using a 29-item modified version of the Cochrane Collaboration Depression, Anxiety and Neurosis Review Group (CCDAN) quality rating scale (Lackner, Mesmer, Morley, Dowzer, & Hamilton, 2004; Moncrieff, Churchill, Drummond, & McGuire, 2001), validated by Lackner et al. (2004).”
MethodJarrett, M. E., Cain, K. C., Barney, P. G., Burr, R. L., Naliboff, B. D., Shulman, R., Zia, J., & Heitkemper, M. M. (2015) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm15067 · Cited by 48
Lackner, J. M., Keefer, L., Jaccard, J. J., Firth, R. S., Brenner, D. M., Bratten, J. R., Dunlap, L. J., Ma, C., & Byroads, M. (2012) · Contemporary Clinical Trials · doi:10.1016/j.cct.2012.07.013 · Cited by 50
“The methodological criterion of blinding participants to assigned treatments is inapplicable to psychological interventions whose content is known to therapists [10].”
Self-citationBehavioral and Complementary Approaches for the Treatment of Irritable Bowel Syndrome
Wald, A., & Rakel, D. (2008) · Nutrition in Clinical Practice · doi:10.1177/0884533608318677 · Cited by 46
Anxiety Disorders and Comorbid Medical Illness
Roy‐Byrne, P., Davidson, K. W., Kessler, R. C., Asmundson, G. J. G., Goodwin, R. D., Kubzansky, L. D., Lydiard, R. B., Massie, M. J., Katon, W. J., Laden, S. K., et al. (2008) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.6.4.foc467 · Cited by 48
Irritable bowel syndrome: new and emerging treatments
Halland, M., & Saito, Y. (2015) · British medical journal · doi:10.1136/bmj.h1622 · Cited by 46
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
Self-citationFoxx–Orenstein, A. E. (2006) · PubMed Central · Cited by 46
Anger and childhood sexual abuse are independently associated with irritable bowel syndrome
Beesley, H., Rhodes, J. M., & Salmon, P. (2009) · British Journal of Health Psychology · doi:10.1348/135910709x466496 · Cited by 45
Sanders, K. A., Blanchard, E. B., & Sykes, M. A. (2007) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-007-9037-7 · Cited by 43
“Although medical treatment of IBS has shown some efficacy (Longstreth and Drossman 2002; Jailwala et al. 2000), psychological treatments have shown great promise in reducing IBS symptomology ( Lackner et al. 2004 ).”
BackgroundDo psychotherapies produce neurobiological effects?
Kumari, V. (2006) · Acta Neuropsychiatrica · doi:10.1111/j.1601-5215.2006.00127.x · Cited by 45
“Some data very relevant to the aim of this article have very recently emerged from a study of patients with irritable bowel syndrome (IBS) (80).”
BackgroundInfluentialClinical trial: the effect of Johrei on symptoms of patients with functional chest pain
Gąsiorowska, A., Navarro-Rodríguez, T., Dickman, R. M., Wendel, C. S., Moty, B., Powers, J., Willis, M. R., Koenig, K., Ibuki, Y., THAI, H., et al. (2008) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2008.03859.x · Cited by 43
Implementing psychological therapies for functional GI disorders in children and adults
Reed, B., Claar, R. L., Schurman, J. V., & van Tilburg, M. A. L. (2016) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2016.1207524 · Cited by 43
“● American Society of Clinical Hypnosis (www.asch.net) ● IBS Focused Hypnosis (www.ibshypnosis.com) ● European Society of Hypnosis (esh_hypnosis.edu)”
InfluentialCassar, G. E., Knowles, S., Youssef, G. J., Moulding, R., Uiterwijk, D., Waters, L., & Austin, D. W. (2018) · Psychology, Health & Medicine · doi:10.1080/13548506.2018.1476722 · Cited by 40
“Visceral sensitivity and pain catastrophizing are considered predictive of IBS symptom severity (Craske et al., 2011; Labus et al., 2004; Lackner et al., 2004; van Tilburg et al., 2013); and are involved in its maintenance and chronicity (Ferreira, Gillanders, Morris, & Eugenicos, 2017; Gwee &…”
BackgroundAnxiety and Related Disorders and Physical Illness
Kariuki, C. M., & Stein, D. J. (2014) · Key issues in mental health (Online)/Key issues in mental health (Print) · doi:10.1159/000365538 · Cited by 45
Psychological approach to managing irritable bowel syndrome
Hayee, B., & Forgács, I. (2007) · BMJ · doi:10.1136/bmj.39199.679236.ae · Cited by 40
“A recent meta-analysis of the efficacy of cognitive behaviour therapy (50% reduction of symptoms) gave an odds ratio of 12 (95% confidence interval 5.56 to 25.96) in favour of cognitive behaviour therapy, with a number needed to treat of 2.”
MethodInfluentialSchröder, A., & Fink, P. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.05.008 · Cited by 39
Yoga as a Therapy for Irritable Bowel Syndrome
D’Silva, A., MacQUEEN, G. M., Nasser, Y., Taylor, L., Vallance, J. K., & Raman, M. (2019) · Digestive Diseases and Sciences · doi:10.1007/s10620-019-05989-6 · Cited by 47
Henrich, J. F., Knittle, K. P., Gucht, V. D., Warren, S., Dombrowski, S. U., & Maes, S. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.12.009 · Cited by 40
“[13] Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S.”
BackgroundResultInfluentialStruggling with an unfamiliar and unreliable body: the experience of irritable bowel syndrome
Håkanson, C., Sahlberg‐Blom, E., Nyhlin, H., & Ternestedt, B. (2009) · Journal of Nursing and Healthcare of Chronic Illness · doi:10.1111/j.1365-2702.2008.01001.x · Cited by 38
Metadata
- Authors
- Lackner, J. M., Mesmer, C., Morley, S., Dowzer, C., & Hamilton, S.
- Affiliations
- Erie County Medical Center (US)
- University at Buffalo, State University of New York (US)
- University of Leeds (GB)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2004
- Volume
- 72
- Issue
- 6
- Pages
- 1100-1113
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2043126698
- Cited by
- 295
- References
- 97
- Citations by year
- 2025: 5 · 2024: 11 · 2023: 4 · 2022: 9 · 2021: 2 · 2020: 9 · 2019: 12 · 2018: 9 · 2017: 10 · 2016: 7 · 2015: 14 · 2014: 21 · 2013: 20 · 2012: 19
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK054211, DK-54211)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- irritable bowel syndrome, psychological intervention, symptom relief, treatment efficacy, psychotherapy, number needed to treat
- MeSH terms
- Humans, Psychotherapy, Irritable Bowel Syndrome
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