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Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome.

12 Sep

A randomized, controlled study at King’s College in London shows that cognitive behavioral therapy with anti-spasmodic medication works better than the medication alone, with positive effects lasting for at least 6 months..

In this randomized, controlled clinical trial, primary care researchers from King''s College in London, looked at the efficacy of cognitive behavioral therapy (CBT) in treating irritable bowel syndrome. From 10 different general medicine practices in London, 149 patients were recruited for the study. They had moderate or severe irritable bowel syndrome, resistant to the antispasmodic drug, mebeverine.

Of 334 referred patients, 72 were randomized to the group that received 270 mg of mebeverine plus CBT; and 77 received mebeverine alone. Patients were measured on the Irritable Bowel Syndrome Symptom Severity Scale, and were also scored on the Work and Social Adjustment Scale and the Hospital Anxiety and Depression Scale.

The study found that the cognitive behavioral therapy had considerable initial benefit on symptom severity when compared with mebeverine alone, with a mean reduction in score of 68 points (95% confidence interval 103 to 33), with the benefit persisting at three months and six months after therapy, but no later than that. CBT also showed significant benefit on the work and social adjustment scale, and this was present 12 months after therapy. Effects on the Hospital Anxiety and Depression scale were inconsistent.

The study concludes that CBT delivered by primary care nurses offers additional benefit over mebeverine alone up to six months, although the effect had waned by 12 months, and that this approach can be useful for certain patients with irritable bowel syndrome in primary care.

Citation: Kennedy T, Jones R, Darnley S, Seed P, Wessely S, Chalder T. Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial. BMJ. 2005 Aug 20;331(7514):435. Epub 2005 Aug 10. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award