Cognitive-Behavioural Therapy for Inflammatory Bowel Disease: 24-Month Data from a Randomised Controlled Trial

Area of Science:

• Gastroenterology
• Psychiatry
• Clinical Trials

Background:

• The effectiveness of psychotherapy, specifically cognitive-behavioural therapy (CBT), in managing inflammatory bowel disease (IBD) remains controversial.
• While CBT may alleviate psychological distress like anxiety and depression in IBD patients, its impact on physical disease course and long-term outcomes is under-researched.

Purpose of the Study:

• To investigate the long-term impact of CBT on the disease course of patients with inflammatory bowel disease (IBD).
• To compare standard care plus CBT with standard care alone in a pragmatic randomized controlled trial over a 24-month period.

Main Methods:

• A two-arm pragmatic randomized controlled trial comparing standard care plus CBT (+CBT) with standard care (SC) alone.
• CBT was delivered over 10 weeks, either face-to-face (F2F) or online (cCBT).
• Data were analyzed using linear mixed-effects models to assess disease activity, blood parameters, mental health, coping, and quality of life over 24 months.

Main Results:

• CBT did not significantly alter disease activity indices (CDAI, SCCAI) or key blood parameters (CRP, Hb, platelet, WCC) at 24 months.
• No significant improvements were observed in mental health, coping strategies, or quality of life among patients receiving CBT compared to standard care alone.
• All tested outcomes showed no statistically significant difference between the +CBT and SC groups (p > 0.05).

Conclusions:

• Cognitive-behavioural therapy (CBT) does not appear to influence the disease course of inflammatory bowel disease (IBD) over a 24-month period.
• High attrition rates, particularly in the CBT group, suggest a need for more personalized psychotherapy approaches in future IBD trials.
• Consideration should be given to hybrid models, combining online and one-to-one therapist delivery, to improve engagement and adherence in IBD psychotherapy interventions.