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Cognitive-behavioral therapy for irritable bowel syndrome: a meta-analysis
Li Li1, Lishou Xiong1, Shenghong Zhang1
1Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Cognitive behavioral therapy (CBT) significantly improves irritable bowel syndrome (IBS) bowel symptoms and quality of life compared to waiting lists or basic medical care. However, its superiority over other psychological treatments for IBS patients was not established.
Area of Science:
- Gastroenterology
- Psychiatry
- Clinical Psychology
Background:
- Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by altered bowel habits and abdominal pain.
- Psychological factors play a significant role in the pathophysiology and symptom perception of IBS.
- Cognitive behavioral therapy (CBT) is a widely used psychotherapeutic approach that has shown promise in managing chronic conditions.
Purpose of the Study:
- To systematically evaluate the efficacy of CBT in improving bowel symptoms, quality of life (QOL), and psychological states in patients with IBS.
- To compare the effects of CBT against various control conditions, including waiting lists, basic support, medical treatment, and other psychological interventions.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science to identify relevant randomized controlled trials (RCTs).
- Meta-analysis was performed to calculate the standardized mean difference (SMD) with 95% confidence intervals (CIs) for key outcome measures.
- Subgroup analyses were conducted to explore potential moderators of treatment effects.
Main Results:
- Eighteen RCTs met the inclusion criteria, involving adult IBS patients.
- CBT demonstrated significant improvements in IBS bowel symptoms, QOL, and psychological states compared to waiting list controls at post-treatment and short-term follow-up.
- While CBT showed benefits over basic support and medical treatment for bowel symptoms, it was not superior in improving QOL or psychological states. Effects were non-significant when compared to other psychological interventions.
Conclusions:
- CBT is an effective intervention for improving bowel symptoms and QOL in IBS patients when compared to waiting list, basic support, or medical treatment.
- CBT's superiority over other psychological treatments for IBS was not demonstrated in this meta-analysis.
- Limitations include potential heterogeneity and small sample sizes in the included studies, warranting cautious interpretation.
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