Journal Article

INSPIRE study: Does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or crohn's disease? A randomized controlled trial

Jahnsen, Jorgen, Rivenes, Ann Christin, Mokleby, Kjell, Pripp, Are H., Dahlstroem, Astri, Sharpe, Michael, Roseth, Arne, Blomhoff, Svein, Wojniusz, Swavek, Benninghoven, Dieter, Lundin, Knut E.A., Wilhelmsen, Ingvard, Tangen, Tone, Jantschek, Günter, Malt, Ulrik F., Boye, Birgitte, Hausken, Trygve, Leganger, Siv, Jantschek, Ingrid, Kunzendorf, Sebastian

2011

Overview

The use of stress management psychotherapy is hypothesized to produce greater improvement in disease course and disease-specific quality of life (IBDQ) compared to usual medical care alone in patients with ulcerative colitis (UC) or Crohn's disease (CD) showing high levels of stress (based on the Perceived Stress Questionnaire [PSQ]).MethodsFifty-eight patients with UC and 56 patients with CD who had experienced continuous disease activity or had relapsed over the previous 18 months, with an activity index for UC or CD ≥4, a PSQ ≥60, and without serious psychiatric disorders or other serious medical conditions were randomized to receive either treatment as usual (TAU) or TAU plus stress management psychotherapy. Psychotherapy consisted of three group sessions (psychoeducation, problem-solving, relaxation) and 6–9 individual sessions based on cognitive behavior therapy-related methods with 1–3 booster sessions at 6 and 12 months follow-up. Gastroenterologists blinded to intervention group assessed disease activity and course at baseline and at 3, 6, 12, and 18 months. Patients completed the IBDQ at baseline, 6, 12, and 18 months.ResultsThe intervention did not improve disease or reduce relapse; however, it increased the IBDQ score (P = 0.009, mean differences 16.3 [SD 6.1]). On analysis of UC and CD separately, improvement of IBDQ was only found in the UC group.ConclusionsStress management psychotherapy does not appear to improve disease course or reduce relapse in patients with IBD. It might improve quality of life, particularly in patients with UC. (Inflamm Bowel Dis 2011;)

• Publisher: Oxford University Press,Wiley Subscription Services, Inc., A Wiley Company
• Subject: Adolescent / Adult / Clinical trials / Cognition & reasoning / Cognitive ability / Cohort Studies / Colitis, Ulcerative - complications / Colitis, Ulcerative - psychology / Colitis, Ulcerative - therapy / Crohn Disease - complications / Crohn Disease - psychology / Crohn Disease - therapy / Crohn's disease / Female / Humans / Inflammatory bowel disease / Inflammatory bowel diseases / Intestine / Inventories / Male / Mental disorders / Middle Aged / Neurotic Disorders - etiology / Neurotic Disorders - therapy / Problem solving / Prognosis / Psychotherapy / Quality of Life / Recurrence / Stress / stress management / Stress, Psychological - therapy / Surveys and Questionnaires / Ulcerative colitis / Young Adult