Durability and Decay of Treatment Benefit of Cognitive Behavioral Therapy for Irritable Bowel Syndrome: 12-Month Follow-Up

Jeffrey M. Lackner, James Jaccard, Christopher D. Radziwon, Rebecca S. Firth, Gregory D. Gudleski, Frank Hamilton, Leonard A. Katz, Laurie Keefer, Susan S. Krasner, Chang Xing Ma, Michael D. Sitrin, Darren M. Brenner

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Abstract

BACKGROUND:There is a need for safe and effective IBS treatments that provide immediate and sustained improvement of IBS symptoms, particularly among more severe patients. The aim was to assess long-term clinical response of cognitive behavioral therapy (CBT) with reference to IBS education.METHODS:A total of 436 Rome III-diagnosed IBS patients (80% F, M age = 41 years) were randomized to: 4 session home-based CBT (minimal contact (MC-CBT)), 10 session clinic-based CBT (standard (S-CBT)), or 4 session IBS education (EDU). Follow-up occurred at 2 weeks and 3, 6, 9, and 12 months following treatment completion. Treatment response was based a priori on the Clinical Global Improvement Scale (global IBS symptom improvement) and IBS Symptom Severity Scale (IBS-SSS).RESULTS:Post-treatment CGI gains were generally maintained by MC-CBT patients at quarterly intervals through 12-month follow-up with negligible decay. For MC-CBT and S-CBT, 39 and 33% of respondents maintained treatment response at every follow-up assessment. The corresponding percent for EDU was 19%, which was significantly lower (p < 0.05) than for the CBT groups. On the IBS-SSS, therapeutic gains also showed a pattern of maintenance with trends towards increased efficacy over time in all conditions, with the mean unit reductions between baseline and follows-up being approximately -76 at immediate and approximately -94 at 12 months (-50 = clinically significant).CONCLUSIONS:For treatment-refractory IBS patients, home- and clinic-based CBT resulted in substantial and enduring relief of multiple IBS symptoms that generally extended to 12-month post treatment.

Original languageEnglish (US)
Pages (from-to)330-338
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume114
Issue number2
DOIs
StatePublished - Feb 1 2019

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Lackner, J. M., Jaccard, J., Radziwon, C. D., Firth, R. S., Gudleski, G. D., Hamilton, F., Katz, L. A., Keefer, L., Krasner, S. S., Ma, C. X., Sitrin, M. D., & Brenner, D. M. (2019). Durability and Decay of Treatment Benefit of Cognitive Behavioral Therapy for Irritable Bowel Syndrome: 12-Month Follow-Up. American Journal of Gastroenterology, 114(2), 330-338. https://doi.org/10.1038/s41395-018-0396-x