C14PSYCHOTHERAPY

StudyParticipantsInterventions
Creed 2003; Trial held in UK; parallel; trial; Setting: secondary careInclusion & Exclusion criteria: IBS>6months; failure to respond to usual medical treatment; severe abdominal pain (>59 on VAS); no contraindications; age 18–65yr Type of IBS: Mixed; IBS definition: Rome I; Severity of IBS symptoms: severe; Bloating/flatus: Not stated; Post infective: not stated Age (range): Mean around 40yr; Gender (M/F): 52:205; Comorbidities: 47% had psychiatric diagnosis (mainly anxiety or depression)29% diarrhoea-predominant IBS; 23% constipation-predominant; 48% general.
  1. Paroxetine (SSRI) (medical treatment); duration: 3 months; frequency/day: once; amount 20mg daily (n=86)
  2. Routine care (usual care); duration: 3 months; (n=86)
  3. Individual psychodynamic interpersonal therapy (n=85)
Guthrie 1991; Trial held in UK; parallel; trial; Setting: secondary careInclusion & Exclusion criteria: IBS > 1 yr; symptoms not improved with medical treatment (bulking agents, +/or antispasmodics) over 6 months. Excluded if severe depression requiring medication or could not speak English Type of IBS: Unclear; IBS definition: 'Had IBS'; Severity of IBS symptoms: moderate; Bloating/flatus: Not stated; Post infective: not stated Age (range): median around 48yr (20–75yr); Gender (M/F): 25:77; Comorbidities: 30% major depression + 18% anxiety states. Medical treatment (bulking agents, +/or antispasmodics) continued unchanged throughout trial. Psychotherapy over 7 sessions (2+hours); relaxation tape to use at home. Median around 4 yr symptoms (range 1–20yr). Median severity 5 (range 2–8) on scale 0–9.
  1. Dynamic psychotherapy, relaxation + medical treatment (psychotherapy); duration: 3 months; frequency/day: ; amount psychotherapy 7 sessions (2+hrs); home relaxation (n=53)
  2. Medical treatment; duration: 3 months (n=49)
Svedlund 1983; Trial held in Sweden; parallel; trial; Setting: secondary careInclusion & Exclusion criteria: Abdo pain and/or change in bowel habit (constipation, diarrhoea or both) Type of IBS: Unclear; IBS definition: 'Had IBS'; Severity of IBS symptoms: Not stated; Bloating/flatus: Not stated; Post infective: not stated Age (range): mean around 34 yr (17–59); Gender (M/F): 31:70; Comorbidities: not stated Conventional medical treatment = bulk-forming agents, anticholinergic drugs, antacids and minor tranquillisers. Psychotherapy modified maladaptive behaviour, found new solutions, focused on coping with stress & emotional probs
  1. Dynamically orientated individual psychotherapy + medical treatment (psychotherapy); duration: 3 months; amount 10 sessions over 3 months (n=50)
  2. Conventional medical treatment (medical treatment) (n=51)

From: Appendix C, Characteristics of included studies

Cover of Irritable Bowel Syndrome in Adults
Irritable Bowel Syndrome in Adults: Diagnosis and Management of Irritable Bowel Syndrome in Primary Care [Internet].
NICE Clinical Guidelines, No. 61.
National Collaborating Centre for Nursing and Supportive Care (UK).
Copyright © 2008, Royal College of Nursing.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.