Durability and Decay of Treatment Benefit of Cognitive Behavioral Therapy for Irritable Bowel Syndrome: 12-Month Follow-Up
Open accessAbstract
BACKGROUND: There is a need for safe and effective IBS treatments that provide immediate and sustained improvement of IBS symptoms, particularly among more severe patients. The aim was to assess long-term clinical response of cognitive behavioral therapy (CBT) with reference to IBS education. METHODS: A total of 436 Rome III-diagnosed IBS patients (80% F, M age = 41 years) were randomized to: 4 session home-based CBT (minimal contact (MC-CBT)), 10 session clinic-based CBT (standard (S-CBT)), or 4 session IBS education (EDU). Follow-up occurred at 2 weeks and 3, 6, 9, and 12 months following treatment completion. Treatment response was based a priori on the Clinical Global Improvement Scale (global IBS symptom improvement) and IBS Symptom Severity Scale (IBS-SSS). RESULTS: Post-treatment CGI gains were generally maintained by MC-CBT patients at quarterly intervals through 12-month follow-up with negligible decay. For MC-CBT and S-CBT, 39 and 33% of respondents maintained treatment response at every follow-up assessment. The corresponding percent for EDU was 19%, which was significantly lower ( p < 0.05) than for the CBT groups. On the IBS-SSS, therapeutic gains also showed a pattern of maintenance with trends towards increased efficacy over time in all conditions, with the mean unit reductions between baseline and follows-up being approximately −76 at immediate and approximately −94 at 12 months (−50 = clinically significant). CONCLUSIONS: For treatment-refractory IBS patients, home- and clinic-based CBT resulted in substantial and enduring relief of multiple IBS symptoms that generally extended to 12-month post treatment.
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“Consistent with the literature [52,74], the MCID for within-participant change from baseline for this trial will be defined a priori as a reduction of ≥50 points in the IBS-SSS total score at the postintervention assessment.”
Self-citation
- Authors
- Lackner, J. M., Jaccard, J., Radziwon, C. D., Firth, R. S., Gudleski, G. D., Hamilton, F., Katz, L. A., Keefer, L., Krasner, S. S., Ma, C.-X., Sitrin, M. D., & Brenner, D. M.
- Affiliations
- University at Buffalo, State University of New York (US)
- New York University (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Icahn School of Medicine at Mount Sinai (US)
- Northwestern University (US)
- Corresponding author
- Lackner, Jeffrey M.
- ORCID
- Venue
- American Journal of Gastroenterology
- Published
- 2018-11-02
- Volume
- 114
- Issue
- 2
- Pages
- 330-338
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- PMC
- PMC6737527
- OpenAlex
- W2901469815
- Cited by
- 61
- References
- 30
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 9 · 2022: 3 · 2021: 16 · 2020: 8 · 2019: 8
- FWCI
- 7.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University at Buffalo
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK077738)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- irritable bowel syndrome, cognitive behavioral therapy, treatment durability, home-based therapy, symptom severity, IBS-SSS
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Treatment Outcome, Irritable Bowel Syndrome
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