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Psychological interventions improve mental health in inflammatory digestive diseases: a systematic review and
Diana-Elena Floria1,2, Beatrix Fogarasi1, Edina Tari1,3
1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Background:
Inflammatory digestive diseases can majorly impact the physical and mental well-being of affected patients.
Objectives:
This meta-analysis aimed to assess the efficacy of psychological interventions (including psychotherapy, mindfulness, cognitive-behavioral therapy, relaxation techniques, meditation, stress management, self-help strategies, psychoeducation, motivational interviewing, hypnotherapy, solution-based therapy, and counseling) on mental parameters and disease-related outcomes in this population.
Design:
This was a systematic review and meta-analysis.
Data Sources And Methods:
The systematic search was conducted on July 31, 2025. Randomized controlled trials (RCTs) were eligible. Outcomes were assessed at the end of therapy and at various time points during the follow-up period (short-, mid-, and long-term follow-up). Owing to the differences in scales and questionnaires, the standardized mean difference (SMD) was used to pool effect sizes, along with corresponding 95% confidence interval (CI). Higgins and Thompson's I 2 statistics were used to assess heterogeneity.
Results:
We included 24 RCTs that investigated the effect of psychological interventions on depressive symptoms in inflammatory digestive diseases, totaling 1572 participants. The pooled analysis found that psychological interventions resulted in a moderate reduction of depression compared to controls (SMD -0.46; CI: -0.75; -0.18). Data from 19 RCTs with 1593 patients also demonstrated a moderate reduction in anxiety symptoms in subjects undergoing psychological interventions (SMD -0.58; CI: -0.94; -0.22). The pooled analysis of 13 RCTs with 772 participants found that psychological therapy was associated with a moderate decrease in stress (SMD -0.53; CI: -1.04; -0.03). The additional analysis of follow-up data showed that benefits resulting from treatment gradually decreased, showing no significant difference at the end of the long-term follow-up period.
Conclusion:
Psychological interventions effectively improve mental health-related outcomes in patients with inflammatory digestive diseases. Since benefits from therapy seem to decrease during the follow-up period, repeated interventions may be necessary.
Trial Registration:
The study protocol was prospectively registered on PROSPERO (CRD42021282965).
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