Background: Stress, anxiety and depression have been identified as important factors on the development and course of inflammatory bowel disease (IBD). The aim of this study is to evaluate the efficacy of a psychological intervention programme on the course and quality-of-life of patients with IBD
Methods: IBD Patients were initially evaluated using the following stress questionnaries: Perceived Stress Scale (PSS) and perceived disease stress (EAE); the hospital anxiety and depression scale (HAD) and the quality-of-life questionnaire (IBDQ). Activity of the IBD was measured using the CDAI scale for Crohn's disease and the Mayo score for ulcerative colitis. Patients were randomized to receive or not an intervention cognitive and behavioural therapy program consisting of 8 sessions (90 minutes each). After intervention patients and controls were re-evaluated using the same scales.
Results: A total of 114 patients with IBD (78 Crohn's disease and 36 ulcerative colitis) were included. All the patients had at least one flare during the last 18 months. A total of 58 patients were assigned to the intervention group and 56 to the control group. Mean age 43.41 (SD 11.842) years. Patients included in the intervention and control group did not show differences in CDAI or Mayo score, stress scales, HAD or IBDQ at the baseline evaluation. After intervention, results in the tests were evaluated comparing the intervention versus the control group. There was a significant improvement of PSS (p=0.001), EAE (p=0.0001), anxiety (p=0.006), depression (p=0.008) and quality-of-life IBDQ (p=0.01), especially in its social and emotional dimension (p=0.002) in the intervention group. In the control group only marginal improvement in EAE (p=0.04), anxiety (p=0.01) and depression (p=0.03) were found, whereas no improvement was found in IBDQ and PSS. Patients from both groups showed a reduction in the CDAI scale of Crohn's disease. No changes in Mayo score were found in ulcerative colitis patients.
Conclusions: A psychological intervention program achieves improvement in stress, anxiety and depression scales as well as in quality-of-life in patients with IBD. This improvement was not found in the same way in the control group.