Tracking Anxiety in Chronic Intestinal Failure: The Role of Time in Healing

Introduction: Chronic intestinal failure (CIF) and the resulting dependence on home parenteral nutrition (HPN) often occur abruptly, profoundly disrupting the daily lives of patients and their caregivers. Both groups face persistent psychological and relational challenges, yet evidence on their long-term mental-health trajectories remains scarce. This study aimed to assess the progression of anxiety symptoms over 12 months in CIF patient-caregiver pairs, and to explore whether participation in a systemic-relational psychotherapy program could influence these outcomes. Methods: The Hamilton Anxiety Rating Scale (HAM-A) was administered to all participating patient-caregiver pairs, who were also invited to attend free biweekly psychotherapy sessions for one year. Pairs who accepted (Group Y) were compared with those who declined (Group N). Results: At baseline, both patients and caregivers in both groups exhibited high anxiety levels. Group Y (n = 10) patients had significantly higher total HAM-A scores than Group N (n = 40) patients (p = 0.048); a similar, non-significant trend was observed among caregivers. Emotional and somatic component scores remained largely unchanged at 6 and 12 months, regardless of group allocation. Conclusions: CIF imposes a substantial and persistent anxiety burden on both patients and caregivers. In this cohort, a brief systemic-relational psychotherapy program, offered quarterly, did not significantly modify anxiety levels over 12 months. These findings highlight the need for more intensive, sustained, and possibly earlier psychological interventions tailored to the dyadic experience of living with CIF and HPN.