[Functional gastrointestinal diseases. Psychotherapy is an efficient complement to drug therapy]

Area of Science:

• Gastroenterology
• Psychology
• Clinical Medicine

Background:

• Functional gastrointestinal disorders (FGIDs) represent a significant clinical challenge.
• Psychological interventions are increasingly recognized for their potential efficacy in managing FGIDs.
• Irritable bowel syndrome (IBS) is the most studied FGID in relation to psychological treatments.

Purpose of the Study:

• To review controlled studies comparing psychological treatments with conventional medical treatments for FGIDs.
• To evaluate the efficacy of psychological interventions in reducing gastrointestinal symptoms.
• To assess the long-term effectiveness and maintenance of gains from psychological treatments.

Main Methods:

• A systematic review of 22 controlled studies was conducted.
• Studies compared psychological treatments against conventional medical treatment and/or supportive therapy.
• Outcomes assessed included reduction in bowel symptoms and long-term follow-up data.

Main Results:

• Nineteen studies demonstrated statistically significant superiority of psychological treatments over conventional care for symptom reduction.
• Of 12 studies with follow-up, 8 showed sustained superiority of psychological interventions.
• Further improvements or maintenance of gains were observed in 8 studies focusing on psychotherapy recipients.

Conclusions:

• Psychological treatments are generally superior to conventional treatments for functional gastrointestinal disorders.
• Effective psychological approaches include dynamic psychotherapy, hypnosis, cognitive-behavior therapy, and relaxation training.
• Clinicians should utilize experienced-based techniques due to a lack of comparative data on specific modalities.