Randomized controlled trial of cognitive-behavioral and mindfulness-based stress reduction on the quality of life of patients with Crohn disease
Abstract
BACKGROUND: Patients with Crohn disease have debilitating psychological symptoms, mental fatigue, and poor quality of life. Psychological intervention may improve these symptoms. METHODS: We performed a randomized parallel-group physician-blinded trial of cognitive-behavioral and mindfulness-based stress reduction (COBMINDEX) on quality of life and psychological symptoms in adults with mild-moderate Crohn disease. COBMINDEX was taught by social workers in one-on-one video conferences over 3 months; quotidian home practice was mandated. RESULTS: Fifty-five COBMINDEX and 61 waitlist control patients completed the study; mean age was 33 years and 65% of participants were women. At 3 months, COBMINDEX patients had significantly reduced disease activity (per Harvey-Bradshaw Index score, C-reactive protein level, and calprotectin level), increased quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ] score increased from baseline 41 to 50; P < 0.001), decreased psychological symptoms (Global Severity Index [GSI], 0.98-0.70; P < 0.001), reduced fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue, 26-33; P < 0.001), and increased mindfulness disposition (Freiburg Mindfulness Inventory, 33-38; P < 0.001). Waitlist patients had a significant but small change in Harvey-Bradshaw Index, SIBDQ, and GSI scores, without improvement in fatigue or mindfulness. There were significant correlations (0.02 > P < 0.002) in COBMINDEX patients between baseline SIBDQ, GSI, Freiburg Mindfulness Inventory, and Functional Assessment of Chronic Illness Therapy-Fatigue scores with a relative change (baseline to 3 months) of the SIBDQ score, but none among waitlist patients. Predictors of relative change of the SIBDQ score in COBMINDEX patients included the GSI score (90% quantile; coefficient 0.52; P < 0.001), somatization (90%; 0.20; P = 0.001), depression (75%; 0.16; P = 0.03), and phobic anxiety (75%; 0.31; P = 0.008). CONCLUSIONS: COBMINDEX was effective in increasing patients' quality of life and reducing psychological symptoms and fatigue. Patients with severe baseline psychological symptoms benefited the most from COBMINDEX.
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Mindfulness-based stress reduction interventions increase quality of life and reduce psychological symptoms, fatigue, and concentrations of C-reactive protein and faecal calprotectin in IBD.
“Mindfulness-Based Stress Reduction (MBSR) interventions have been shown to increase the quality of life (Jedel et al., 2014; Goren et al., 2022) and reduce psychological symptoms (Drent et al., 2016; Goren et al., 2022), fatigue (Goren et al., 2022), and the concentration of C-reactive Protein (CRP) and faecal calprotectin in IBD (Berrill et al., 2014; Gonzalez-Moret et al., 2020).”
From Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease: the LIFEwithIBD intervention (2024) · cites this paper as Goren et al., 2022
Cites
EuroQol: a new facility for the measurement of health-related quality of life
(1990) · Health Policy · doi:10.1016/0168-8510(90)90421-9 · Cited by 15,736 · see citing works
The brief symptom inventory: an introductory report.
Derogatis, L. R., & Melisaratos, N. (1983) · Psychological Medicine · doi:10.1017/s0033291700048017 · Cited by 6,650 · see citing works
A SIMPLE INDEX OF CROHN'S-DISEASE ACTIVITY
Harvey, R. F., & Bradshaw, J. M. (1980) · The Lancet · doi:10.1016/s0140-6736(80)92767-1 · Cited by 2,974 · see citing works
The global burden of IBD: from 2015 to 2025
Kaplan, G. G. (2015) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2015.150 · Cited by 2,639 · see citing works
Epidemiology and Natural History of Inflammatory Bowel Diseases
Cosnes, J., Gower‐Rousseau, C., Seksik, P., & Cortot, A. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.01.055 · Cited by 2,212 · see citing works
Measuring mindfulness—The Freiburg Mindfulness Inventory (FMI)
Walach, H., Buchheld, N., Buttenmüller, V., Kleinknecht, N., & Schmidt, S. (2006) · Personality and Individual Differences · doi:10.1016/j.paid.2005.11.025 · Cited by 1,475 · see citing works
The Natural History of Adult Crohn's Disease in Population-Based Cohorts
Peyrin‐Biroulet, L., Loftus, E. V., Colombel, J., & Sandborn, W. J. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.579 · Cited by 1,043 · see citing works
Brain–Gut Interactions in Inflammatory Bowel Disease
Bonaz, B. L., & Bernstein, C. N. (2013) · Gastroenterology · doi:10.1053/j.gastro.2012.10.003 · Cited by 667 · see citing works
Irvine, E. J., Zhou, Q., & Thompson, A. K. (1996) · PubMed · Cited by 632 · see citing works
Depression and anxiety in patients with Inflammatory Bowel Disease: a systematic review
Neuendorf, R., Harding, A., Stello, N., Hanes, D., & Wahbeh, H. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.06.001 · Cited by 561 · see citing works
Walker, J. R., Ediger, J. P., Graff, L. A., Greenfeld, J. M., Clara, I., Lix, L., Rawsthorne, P., Miller, N., Rogala, L., McPhail, C. M., et al. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.01980.x · Cited by 437 · see citing works
Vivinus-Nébot, M., Frin-Mathy, G., Bzioueche, H., Dainese, R., Bernard, G., Anty, R., Filippi, J., Saint‐Paul, M., Tulić, M. K., Verhasselt, V., et al. (2013) · Gut · doi:10.1136/gutjnl-2012-304066 · Cited by 365 · see citing works
Mikocka-Walus, A., Pittet, V., Rossel, J.-B., von Känel, R., Anderegg, C., Bauerfeind, P., Beglinger, C., Begré, S., Belli, D., Bengoa, J. M., et al. (2016) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.12.045 · Cited by 348 · see citing works
A population-based study of fatigue and sleep difficulties in inflammatory bowel disease
Graff, L. A., Vincent, N., Walker, J. R., Clara, I. P., Carr, R., Ediger, J. P., Miller, N., Rogala, L., Rawsthorne, P. E., Lix, L. M., et al. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21580 · Cited by 291 · see citing works
World Gastroenterology Organisation Global Guidelines Inflammatory Bowel Disease
Bernstein, C. N., Eliakim, A. R., Fedail, S. S., Fried, M., Gearry, R. B., Goh, K., Hamid, S. S., Khan, A. G., Халиф, И. Л., Ng, S. C., et al. (2016) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000000660 · Cited by 230 · see citing works
Pellissier, S., Dantzer, C., Mondillon, L., Trocme, C., Gauchez, A.-S., Ducros, V., Mathieu, N., Toussaint, B., Fournier, A., Canini, F., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0105328 · Cited by 212 · see citing works
Psychological interventions for treatment of inflammatory bowel disease
Timmer, A., Preiss, J. C., Motschall, E., Rücker, G., Jantschek, G., & Moser, G. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006913.pub2 · Cited by 187 · see citing works
Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases
Ballou, S., & Keefer, L. (2017) · Clinical and Translational Gastroenterology · doi:10.1038/ctg.2016.69 · Cited by 167 · see citing works
IBS and IBD — separate entities or on a spectrum?
Spiller, R. E., & Major, G. (2016) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2016.141 · Cited by 166 · see citing works
Tinsley, A., Macklin, E. A., Korzenik, J., & Sands, B. E. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04871.x · Cited by 148 · see citing works
Coping Strategies and Quality of Life of Adolescents with Inflammatory Bowel Disease
van der Zaag–Loonen, H. J., Grootenhuis, M. A., Last, B. F., & Derkx, H. H. F. (2004) · Quality of Life Research · doi:10.1023/b:qure.0000025598.89003.0c · Cited by 147 · see citing works
Berrill, J. W., Sadlier, M., Hood, K., & Green, J. T. (2014) · Journal of Crohn's and Colitis · doi:10.1016/j.crohns.2014.01.018 · Cited by 123 · see citing works
Infliximab for Crohn’s Disease: More Than 13 Years of Real-world Experience
Lichtenstein, G. R., Feagan, B. G., Cohen, R. D., et al. (2018) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izx072 · Cited by 120 · see citing works
Iglesias–Rey, M., Acosta, M. B., Caamaño‐Isorna, F., Vázquez, I., Ferreiro, R., Lindkvist, B., González, A. L., & Domínguez‐Muñoz, J. E. (2013) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000436955.78220.bc · Cited by 118 · see citing works
Kemp, K. (2012) · World Journal of Gastroenterology · doi:10.3748/wjg.v18.i43.6240 · Cited by 116 · see citing works
Boye, B., Lundin, K. E. A., Jantschek, G., Leganger, S., Mokleby, K., Tangen, T., Jantschek, I., Pripp, A. H., Wojniusz, S., Dahlstroem, A., et al. (2011) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21575 · Cited by 113 · see citing works
Early intervention in Crohn’s disease: towards disease modification trials
Danese, S., Fiorino, G., & Peyrin‐Biroulet, L. (2017) · Gut · doi:10.1136/gutjnl-2017-314519 · Cited by 113 · see citing works
Fatigue in out-patients with inflammatory bowel disease: Prevalence and predictive factors
Villòria, A., Hernando, V. G., Dosal, A., Moreno, L., Montserrat, A., Figuerola, A., Horta, D., Calvet, X., & Ramírez‐Lázaro, M. J. (2017) · PLoS ONE · doi:10.1371/journal.pone.0181435 · Cited by 110 · see citing works
Jelsness‐Jørgensen, L., Bernklev, T., Henriksen, M., Torp, R., & Moum, B. A. (2010) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2010.04498.x · Cited by 107 · see citing works
Knowles, S. R., Monshat, K., & Castle, D. J. (2013) · Inflammatory Bowel Diseases · doi:10.1097/mib.0b013e318296ae5a · Cited by 102 · see citing works
Advocat, J., Enticott, J., Vandenberg, B., Hassed, C., Hester, J., & Russell, G. (2016) · BMC Neurology · doi:10.1186/s12883-016-0685-1 · Cited by 94 · see citing works
Schoultz, M., Atherton, I., & Watson, A. J. M. (2015) · Trials · doi:10.1186/s13063-015-0909-5 · Cited by 87 · see citing works
Regular review: Ulcerative colitis
Ghosh, S. (2000) · BMJ · doi:10.1136/bmj.320.7242.1119 · Cited by 86 · see citing works
Neilson, K., Ftanou, M., Monshat, K., Salzberg, M., Bell, S., Kamm, M. A., Connell, W., Knowles, S. R., Sevar, K., Mancuso, S. G., et al. (2016) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000629 · Cited by 80 · see citing works
Burisch, J. M., Weimers, P., Pedersen, N., Cukovic-Cavka, S., Vucelic, B. N., Kaimakliotis, I. P., Duricova, D., Bortlík, M., Shonová, O., Vind, I., et al. (2014) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2014.01.028 · Cited by 73 · see citing works
Self-citationAdverse events in IBD therapy: the 2018 update
Quezada, S. M., McLean, L. P., & Cross, R. K. (2018) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2018.1545574 · Cited by 73 · see citing works
Alexakis, C., Kumar, S., Saxena, S., & Pollok, R. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14171 · Cited by 69 · see citing works
Lin, J. E., Neylan, T. C., Epel, E., & O’Donovan, A. (2016) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2015.11.015 · Cited by 63 · see citing works
Management of stress in inflammatory bowel disease: a therapeutic option?
Goodhand, J., Wahed, M., & Rampton, D. S. (2009) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/egh.09.55 · Cited by 56 · see citing works
Determinants of fatigue in Crohn’s disease patients
Vogelaar, L., Spijker, A. V., van Tilburg, A. J. P., Kuipers, E. J., Timman, R., & van der Woude, C. J. (2012) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0b013e32835aba83 · Cited by 50 · see citing works
McCombie, A., Mulder, R., & Gearry, R. B. (2015) · Inflammatory Bowel Diseases · doi:10.1097/mib.0000000000000476 · Cited by 46 · see citing works
Bartels‐Velthuis, A. A., Schroevers, M. J., der Ploeg, K. M. V., Koster, F., Fleer, J., & van den Brink, E. (2016) · Mindfulness · doi:10.1007/s12671-016-0518-8 · Cited by 38 · see citing works
Differing Relationship of Psycho-Social Variables with Active Ulcerative Colitis or Crohn’s Disease
Sarid, O., Slonim‐Nevo, V., Schwartz, D., Friger, M. D., Sergienko, R., Pereg, A., Vardi, H., Chernin, E., Singer, T., Greenberg, D., et al. (2018) · International Journal of Behavioral Medicine · doi:10.1007/s12529-018-9712-5 · Cited by 20 · see citing works
Self-citationDifferential relationships of somatization, depression, and anxiety to severity of Crohn’s disease
Regev, S., Odes, S., Slonim‐Nevo, V., Friger, M. D., Schwartz, D., Sergienko, R., Eliakim, R., & Sarid, O. (2020) · Journal of Health Psychology · doi:10.1177/1359105320909879 · Cited by 19 · see citing works
Self-citationWorkplace Accommodation for Persons With IBD: What Is Needed and What Is Accessed
Chhibba, T., Walker, J. R., Sexton, K. A., Restall, G. J., Ivekovic, M., Shafer, L. A., Singh, H., Targownik, L. E., & Bernstein, C. N. (2017) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2017.05.046 · Cited by 18 · see citing works
Seyedian, S. S., Nazarinasab, M., Nematpour, S., & Esfahanian, N. (2019) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_236_18 · Cited by 1 · see citing works
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Ge, L., Liu, S., Li, S., Yang, J., Hu, G., Xu, C., & Song, W. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.1016578 · Cited by 187 · see citing works
Riggott, C., Mikocka-Walus, A., Gracie, D. J., & Ford, A. C. (2023) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(23)00186-3 · Cited by 83 · see citing works
Shchaslyvyi, A. Y., Antonenko, S. V., & Telegeev, G. D. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21081077 · Cited by 73 · see citing works
Peerani, F., Watt, M., Ismond, K. P., Whitlock, R., Ambrosio, L., Hotte, N., Mitchell, N., Bailey, R. J., Kroeker, K., Dieleman, L. A., et al. (2022) · Therapeutic Advances in Gastroenterology · doi:10.1177/17562848221127238 · Cited by 35 · see citing works
Ferreira, C., Pereira, J., Skvarc, D., Oliveira, S., Galhardo, A., Ferreira, N. B., Lucena-Santos, P., Carvalho, S. A., Matos-Pina, I., Rocha, B. S., et al. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1367913 · Cited by 12 · see citing works
Tse, C. S., Singh, S., & Sandborn, W. J. (2022) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izab153 · Cited by 3 · see citing works
Chen, Y.-T., Lehman, M., Van Denend, T., Kish, J., Wu, Y., Preissner, K., Plow, M., & Packer, T. L. (2025) · Journal of Medical Internet Research · doi:10.2196/58543 · Cited by 3 · see citing works
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Influential
- Authors
- Goren, G., Schwartz, D., Friger, M., Banai, H., Sergienko, R., Regev, S., Abu-Kaf, H., Greenberg, D., Nemirovsky, A., Ilan, K., Lerner, L., Monsonego, A., Dotan, I., Yanai, H., Eliakim, R., Ben Horin, S., Slonim-Nevo, V., Odes, S., & Sarid, O.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Tel Aviv University (IL)
- Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
- Spitzer Department of Social Work, Ben-Gurion University of the Negev , Beer Sheva , Israel
- Corresponding author
- Odes, Shmuel
- ORCID
- Venue
- Inflammatory Bowel Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-04-13
- Volume
- 28
- Issue
- 3
- Pages
- 393-408
- ISSN
- 1078-0998 (ISSN-L)
- 1536-4844
- OpenAlex
- W3156615571
- Cited by
- 56
- References
- 46
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 15 · 2023: 6 · 2022: 8 · 2021: 3
- FWCI
- 5.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Inflammatory Bowel Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Leona M. and Harry B. Helmsley Charitable Trust
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- Crohn's disease, cognitive behavioral therapy
- MeSH terms
- Adult, Cognition, Crohn Disease, Depression, Female, Humans, Quality of Life, Stress, Psychological, Mindfulness
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