Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis
Open accessAbstract
BACKGROUND: Psychotherapy is not routinely recommended for in ulcerative colitis (UC). Gut-directed hypnotherapy (HYP) has been linked to improved function in the gastrointestinal tract and may operate through immune-mediated pathways in chronic diseases. AIMS: To determine the feasibility and acceptability of HYP and estimate the impact of HYP on clinical remission status over a 1-year period in patients with an historical flare rate of 1.3 times per year. METHODS: A total of 54 patients were randomised at a single site to seven sessions of gut-directed HYP (n = 26) or attention control (CON; n = 29) and followed for 1 year. The primary outcome was the proportion of participants in each condition that had remained clinically asymptomatic (clinical remission) through 52 weeks post treatment. RESULTS: One-way analysis of variance comparing HYP and CON subjects on number of days to clinical relapse favoured the HYP condition [F = 4.8 (1, 48), P = 0.03] by 78 days. Chi-squared analysis comparing the groups on proportion maintaining remission at 1 year was also significant [χ²(1) = 3.9, P = 0.04], with 68% of HYP and 40% of CON patients maintaining remission for 1 year. There were no significant differences between groups over time in quality of life, medication adherence, perceived stress or psychological factors. CONCLUSION: This is the first prospective study that has demonstrated a significant effect of a psychological intervention on prolonging clinical remission in patients with quiescent ulcerative colitis (Clinical Trial # NCT00798642).
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Only three intervention studies confirmed that intervention and comparator groups had similar baseline characteristics.
“Only three studies 34 , 41 , 58 confirmed that intervention and comparator groups had similar baseline characteristics”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [41]
The Statistical Analysis section says the study compared baseline demographic and disease variables between the hypnotherapy and control groups. The Discussion reports no detected difference in baseline treatment expectancy, but the passages do not confirm that the groups had similar baseline characteristics generally. This paper also cannot establish the citing document’s count of only three studies. (LLM, conf=0.75)
Experimental — accuracy not yet measuredHypnotherapy did not affect perceived stress.
“Hypnotherapy did not affect perceived stress. 41”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [41]
Emerging data suggest that psychological therapies may have positive effects on IBD outcomes, prolonging remission for adults with ulcerative colitis.
“Emerging data suggest that psychological therapies may have positive effects on IBD outcomes, prolonging remission for adults with ulcerative colitis (68,69)”
From The 2023 Impact of Inflammatory Bowel Disease in Canada: Mental Health and Inflammatory Bowel Disease (2023) · cites this paper as [69]
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Tarricone, I., Regazzi, M. G., Bonucci, G., Rizzello, F., Carini, G., Muratori, R., Poggioli, G., & Campieri, M. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.07.001 · Cited by 53 · see citing works
Resilience-based integrated IBD care is associated with reductions in health care use and opioids
Keefer, L., Gorbenko, K., Siganporia, T., Manning, L., Tse, S., Biello, A., Ungaro, R., Cohen, L. J., Cohen, B. L., & Dubinsky, M. C. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2021.11.013 · Cited by 49 · see citing works
The effect of psychotherapy on quality of life in IBD Patients: A systematic review
Paulides, E., Boukema, I., van der Woude, C. J., & de Boer, N. K. H. (2021) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izaa144 · Cited by 47 · see citing works
Philippou, A., Sehgal, P., Ungaro, R. C., Wang, K., Bagiella, E., Dubinsky, M. C., & Keefer, L. (2022) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izab200 · Cited by 43 · see citing works
Self-citationPeerani, 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
The role of hypnotherapy for the treatment of inflammatory bowel diseases
Moser, G. (2014) · Expert Review of Gastroenterology & Hepatology · doi:10.1586/17474124.2014.917955 · Cited by 33 · see citing works
Graff, L. A., Geist, R., Kuenzig, M. E., Benchimol, E. I., Kaplan, G. G., Windsor, J. W., Bitton, A., Coward, S., Jones, J. L., Lee, K., et al. (2023) · Journal of the Canadian Association of Gastroenterology · doi:10.1093/jcag/gwad012 · Cited by 30 · see citing works
“Emerging data suggest that psychological therapies may have positive effects on IBD outcomes, prolonging remission for adults with ulcerative colitis (68,69) and potentially through reducing inflammatory responses (70), although other studies have not found improved disease outcomes after an extended time (71).”
BackgroundTrindade, I. A., Pereira, J., Galhardo, A., Ferreira, N. B., Lucena-Santos, P., Carvalho, S. A., Oliveira, S., Skvarc, D., Rocha, B. S., Portela, F., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.699367 · Cited by 20 · see citing works
Dossett, M. L., Korzenik, J. R., Baim, M., Denninger, J. W., & Mehta, D. H. (2016) · Global Advances in Health and Medicine · doi:10.7453/gahmj.2015.118 · Cited by 5 · see citing works
- Authors
- Keefer, L., Taft, T. H., Kiebles, J. L., Martinovich, Z., Barrett, T. A., & Palsson, O. S.
- Affiliations
- Northwestern University (US)
- Edward Hines, Jr. VA Hospital (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Keefer, L.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2013-08-19
- Volume
- 38
- Issue
- 7
- Pages
- 761-771
- ISSN
- 0269-2813 (ISSN-L)
- PMC
- PMC4271841
- OpenAlex
- W1991923515
- Semantic Scholar
- 348934fa27e87ccf2ffa18dae16b822cbc45f016
- Cited by
- 132
- References
- 74
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 14 · 2023: 13 · 2022: 13 · 2021: 8 · 2020: 11 · 2019: 6 · 2018: 7 · 2017: 14 · 2016: 9 · 2015: 14 · 2014: 4 · 2013: 1
- FWCI
- 6.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health (R21AT003204, R21AT0032004)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- gut-directed hypnotherapy, ulcerative colitis, clinical remission, psychotherapy, clinical relapse, feasibility and acceptability, psychological intervention, quality of life, perceived stress
- MeSH terms
- Adult, Colitis, Ulcerative, Feasibility Studies, Female, Humans, Hypnosis, Male, Middle Aged, Prospective Studies, Recurrence, Remission Induction, Treatment Outcome, Medication Adherence
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