Cited by 86Inflammatory Bowel DiseaseMindfulness and Compassion InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Cognitive-behavioural therapy has no effect on disease activity but improves quality of life in subgroups of patients with inflammatory bowel disease: a pilot randomised controlled trial

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Mikocka-Walus, Antonina, Bampton, Peter, Hetzel, David, Hughes, Patrick, Esterman, Adrian, Andrews, Jane M·2015·BMC Gastroenterology

Abstract

BACKGROUND: Studies have demonstrated usefulness of cognitive-behavioural therapy (CBT) in managing distress in inflammatory bowel disease (IBD); however, few have focused on IBD course. The present trial aimed to investigate whether adding CBT to standard treatment prolongs remission in IBD in comparison to standard therapy alone. METHODS: A 2-arm parallel pragmatic randomised controlled trial (+CBT - standard care plus either face-to-face (F2F) or online CBT over 10 weeks versus standard care alone (SC)) was conducted with adult patients in remission. IBD remission at 12 months since baseline was the primary outcome measure while the secondary outcome measures were mental health status and quality of life (QoL). Linear mixed-effect models were used to compare groups on outcome variables while controlling for baseline. RESULTS: Participants were 174 patients with IBD (90 +CBT, 84 SC). There was no difference in remission rates between groups, with similar numbers flaring at 12 months. Groups did not differ in anxiety, depression or coping at 6 or 12 months (p >0.05). When only participants classified as 'in need' (young, high baseline IBD activity, recently diagnosed; poor mental health) were examined in the post-hoc analysis (n = 74, 34 CBT and 40 controls), CBT significantly improved mental QoL (p = .034, d = .56) at 6 months. Online CBT group had a higher score on Precontemplation than the F2F group, which is consistent with less developed coping with IBD in the cCBT group (p = .045). CONCLUSIONS: Future studies should direct psychological interventions to patients 'in need' and attempt to recruit larger samples to compensate for significant attrition when using online CBT. TRIAL REGISTRATION: The protocol was registered on 21/10/2009 with the Australian New Zealand Clinical Trials Registry (ID: ACTRN12609000913279).

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  • This pattern of higher retention in active control is not unusual and has been found in similar trials testing psychotherapy for IBD.

    “This is not an unusual finding and has been found in similar trials testing psychotherapy for IBD.37”

    From Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress. (2024) · cites this paper as [37]

    The Results (Attrition) report higher dropout in the CBT group than in the standard-care group at both 6 and 12 months, supporting the claim that control participants were retained at a higher rate in a psychotherapy trial for IBD. The paper does not establish that this pattern is common across similar trials, and its comparator was standard care rather than a control described as active. (LLM, conf=0.84)

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  • The present trial showed high retention, comparable to or better than other trials testing psychotherapy, specifically CBT, in an online only setting for IBD.

    “The present trial showed high retention, which is comparable to or better than other trials testing psychotherapy, specifically CBT, in an online only setting for IBD.37,40”

    From Feasibility, Acceptability, and Preliminary Efficacy of Acceptance Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress. (2024) · cites this paper as [37]

    The Methods (Design and Procedure) describe an IBD trial that offered both online and face-to-face CBT, so it was not an online-only trial. The Results (Attrition) provide a relevant comparison for the online CBT subgroup: 48% were lost to follow-up at six months and 60% at twelve months. The cited paper supports an online-CBT retention comparison, but not the description of the whole trial as online-only. (LLM, conf=0.87)

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Authors
Mikocka-Walus, A., Bampton, P., Hetzel, D., Hughes, P., Esterman, A., & Andrews, J. M.
Affiliations
  • Flinders University (AU)
  • Royal Adelaide Hospital (AU)
  • The University of Adelaide (AU)
  • University of South Australia (AU)
Venue
BMC Gastroenterology
Published
2015-05-02
Volume
15
Issue
1
Pages
54-54
ISSN
1471-230X (ISSN-L)
OpenAlex
W2000130446
Cited by
86
References
45
Citations by year
2026: 4 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 9 · 2020: 7 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 10 · 2015: 1
FWCI
5.86
Type
journal article
Language
en
Open access
Locations
  • BMC Gastroenterology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • ResearchOnline - JCU (James Cook University) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • Own your potential (DEAKIN) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • UniSA Research Outputs Repository (University of South Australia) (submittedVersion, other-oa)
Funders
  • University of Warwick
  • MSD Australia
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
cognitive behavioral therapy, inflammatory bowel disease, remission, disease activity, quality of life, mental health, coping, precontemplation, anxiety, depression, psychological intervention
MeSH terms
Adult, Combined Modality Therapy, Female, Health Status, Humans, Male, Mental Health, Middle Aged, Pilot Projects, Quality of Life, Remission Induction, Inflammatory Bowel Diseases, Cognitive Behavioral Therapy, Linear Models, Treatment Outcome

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