Prediction of symptomatic improvement after exposure-based treatment for irritable bowel syndrome

BMC Gastroenterology

Research Article

Hugo Hesser¹  Erik Andersson²  Evelyn Andersson²  Brjánn Ljótsson³  Erik Hedman⁴  Perjohan Lindfors⁵  Jeffrey M Lackner⁶  Johanna Norén⁷  Karin Romberg⁷  Timo Hursti⁷  Karin Grönberg⁷  Katarina Molin⁷ 

[1] Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden;Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden;Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 171 65, Stockholm, Sweden;Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 171 65, Stockholm, Sweden;Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden;Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden;Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden;Department of Medicine, University at Buffalo School of Medicine and Biomedical Science, ECMC, Buffalo, NY, USA;Department of Psychology, Uppsala University, Uppsala, Sweden;

关键词: Irritable bowel syndrome;    Exposure;    Internet;    Cognitive behavior therapy;    Psychological treatment;    Prediction analysis;   

DOI  :  10.1186/1471-230X-13-160

 received in 2013-06-12, accepted in 2013-11-14,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundSeveral studies show that psychological treatments relieve symptoms for patients suffering from irritable bowel syndrome (IBS). However, there are no consistent findings that show what patient characteristics make a psychological treatment more or less likely to result in improvement. We have previously conducted a study of a newly developed internet-delivered cognitive behavioral therapy (ICBT) that emphasized exposure to IBS symptoms and IBS-related situations and reduced symptom-related avoidance. The study showed that the treatment led to improvement in IBS symptoms compared to a waiting list and that treatment gains were maintained over a 15–18 month follow-up period. The aim of the present study was to investigate several possible predictors of short- and long-term treatment outcome in terms of symptom improvement, based on data collected in the previously conducted treatment trial.MethodsDemographics, comorbid psychological distress, IBS-related fear and avoidance behaviors, and IBS-related disability were investigated as predictors of treatment outcome in the sample consisting of 79 participants diagnosed with IBS who had undergone 10 weeks of ICBT. Predictors that were significantly correlated with symptom levels at post-treatment and follow-up were entered into multiple regression analyses that controlled for pre-treatment symptom levels.ResultsThere were measures within each domain, i.e., comorbid psychological distress, IBS-related fear and avoidance behaviors, and IBS-related disability, with the exception of demographic data, that were correlated with the symptom levels at post-treatment and follow-up. However, when these were entered into a multiple regression analyses that controlled for pre-treatment levels, none remained a significant predictor of the post-treatment and follow-up symptomatic status.ConclusionsThe study did not find any individual characteristics that made patients more or less likely to respond to the exposure-based ICBT. The finding that comorbid psychological distress did not predict outcome is in accordance with previous studies. Reliable predictors for response to any type of psychological treatment for IBS remain to be established.

【 授权许可】

CC BY   
© Ljótsson et al.; licensee BioMed Central Ltd. 2013