Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-30T01:38:15.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive behavior therapy for functional gastrointestinal disorders: is group treatment effective?

Published online by Cambridge University Press:  24 June 2014

Rolf Leibbrand  and
Wolfgang Hiller
Rolf Leibbrand*
Affiliation:
Department for somatoform disorder and tinnitus treatment, Schwedenstein Center for Psychosomatic Medicine, Pulsnitz
Wolfgang Hiller
Affiliation:
Department for Clinical Psychology and Psychotherapy at the Johannes Gutenberg-University of Mainz, Germany
*
Dr Rolf Leibbrand, Klinik Schwedenstein, Obersteinaer Weg 1, 01896 Pulsnitz, Germany. Tel. + 35955 47 504; Fax: + 35955 47 632; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The intention of this study was to evaluate therapy outcome of a cognitive-behavioral group treatment program for functional gastrointestinal disorders. As a particular characteristic, gastrointestinal symptoms were investigated independently from diagnostic categories on a dimensional basis, considering the persistence of symptoms as well as the aspect of severity.

Methods:

A total of 64 subjects participated in the 10-week treatment program, and 49 completed the study. Subjects underwent four assessments (baseline, pre-, post-treatment, 12-month follow-up), each comprising several self-rated questionnaires on gastrointestinal, somatoform, depressive, hypochondriacal and anxious symptoms, and health locus of control, as well as a diagnostic interview of functional gastrointestinal and mental disorders at the baseline assessment. Treatment effects were controlled by subjects' waiting list period before treatment.

Results:

Gastrointestinal symptoms, as well as comorbid psychopathology scores, decreased significantly during treatment and remained unchanged during the follow-up period, whereas no relevant changes were found in health locus of control. Largest effect sizes were found for gastrointestinal symptoms, which decreased by 30–50% of their initial number.

Conclusions:

The group treatment investigated was effective and particularly successful with respect to functional gastrointestinal symptoms. However, the mechanisms of treatment outcome remain indistinct. Further studies comparing different setting conditions directly are required to clarify the question of whether group treatment is significantly superior or inferior to individual therapy.

Keywords

functional gastrointestinal disordersgroup treatmentirritable bowel syndromeoutcomestandardized dimensional assessment
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 15 , Issue 4 , August 2003 , pp. 242 - 248
Copyright
Copyright © 2003 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Herschbach, P, Henrich, G, Von Rad, M. Psychological factors in functional gastrointestinal disorders: characteristics of the disorder or of the illness behavior? Psychosom Med 1999;61: 148–153.CrossRefGoogle ScholarPubMed
Talley, NJ, Zinsmeister, AR, Van Dyke, C, Melton, LJ. Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterology 1991;101: 927–934.CrossRefGoogle ScholarPubMed
Bleijenberg, G, Fennis, JFM. Anamnestic and psychological features in diagnosis and prognosis of functional abdominal complaints: a prospective study. Gut 1989;30: 1076–1081.CrossRefGoogle ScholarPubMed
Fowlie, S, Eastwood, MA, Ford, MJ. Irritable bowel syndrome: the influence of psychological factors on the symptom complex. J Psychosom Res 1992;36: 169–173.CrossRefGoogle ScholarPubMed
Guthrie, E, Creed, F, Dawson, D, Tomenson, B. A controlled trial of psychological treatment for the irritable bowel syndrome. Gastroenterology 1991;100: 450–457.CrossRefGoogle ScholarPubMed
Shaw, G, Srivistava, ED, Sadlier, M. Stress management for irritable bowel syndrome: a controlled trial. Digestion 1991;50: 36–42.CrossRefGoogle ScholarPubMed
Blanchard, EB, Schwarz, SP, Suls, JMet al. Two controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome. Beh Res Ther 1992;30: 175–189. CrossRefGoogle ScholarPubMed
Greene, B, Blanchard, EB. Cognitive therapy for irritable bowel syndrome. J Consult Clin Psychol 1994;62: 576–582.CrossRefGoogle ScholarPubMed
Payne, A, Blanchard, EB. A controlled trial of cognitive therapy and self-help support groups in the treatment of irritable bowel syndrome. J Consult Clin Psychol 1995;63: 779–786.CrossRefGoogle ScholarPubMed
Van Dulmen, AM, Fennis, JF, Bleijenberg, G. Cognitive-behavioral group therapy for irritable bowel syndrome: effects and long-term follow-up. Psychosom Med 1996;58: 508–514.CrossRefGoogle ScholarPubMed
Fernandez, C, Perez, M, Amigo, I, Linares, A. Stress and contingency management in the treatment of irritable bowel syndrome. Stress Med 1998;14: 31–42. 3.0.CO;2-B>CrossRefGoogle Scholar
Heymann-Mönnikes, I, Arnold, R, Florin, I, Herda, C, Melfsen, S, Mönnikes, H. The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. Am J Gastroenterol 2000;95: 981–994.CrossRefGoogle ScholarPubMed
Vollmer, A, Blanchard, EB. Controlled comparison of individual versus group cognitive therapy for irritable bowel syndrome. Beh Ther 1998;29: 19–33. CrossRefGoogle Scholar
Leibbrand, R, Hiller, W. Functional gastrointestinal disorders: cognitive-behaviour treatment. Curr Opin Psychiatry 2002;15: 649–652. CrossRefGoogle Scholar
Hiller, W, Cuntz, U, Rief, W, Fichter, M. Searching for a gastrointestinal subgroup within the somatoform disorders. Psychosomatics 2001;42: 14–20.CrossRefGoogle ScholarPubMed
Nimnuan, C, Rabe-Hesketh, S, Wessely, S, Hotopf, M. How many functional syndromes? J Psychosom Res 2001;51: 549–557.CrossRefGoogle Scholar
Talley, NJ, Stanghellini, V, Heading, RC, Koch, KL, Malagelada, JR, Tytgat, GNJ. Functional gastroduodenal disorders. Gut 1999;45(Suppl. II:): 1137–1142.CrossRefGoogle ScholarPubMed
Thompson, WG, Longstreth, GF, Drossman, DA, Heaton, KW, Irvine, EJ, Müller-Lissner, SA. Functional bowel disorders and functional abdominal pain. Gut 1999;45(Suppl. II:): 1143–1147.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: APA, 1994. Google Scholar
Hiller, W, Zaudig, M, Mombour, W. IDCL: International Diagnostic Checklists for ICD-10 und DSM-IV. Seattle: Hogrefe and Huber, 1996. Google Scholar
Leibbrand, R, Cuntz, U, Hiller, W. Assessment of functional gastrointestinal disorders using the Gastro-Questionnaire. Int J Beh Med 2002;9: 155–172. CrossRefGoogle ScholarPubMed
Rief, W, Hiller, W, Heuser, J. SOMS – Das Screening für somatoforme Störungen [The Screening for Somatoform Disorders]. Bern: Huber, 1997. Google Scholar
Hiller, W, Rief, W, Fichter, MM. Dimensional and categorical approaches to hypochondriasis. Psychol Med 2002;32: 707–718.CrossRefGoogle ScholarPubMed
Beck, AT, Steer, RA. Beck Depression Inventory – Manual. San Antonio: The Psychological Corporation, 1987. Google Scholar
Laux, L, Glanzmann, P, Schaffner, P, Spielberger, CD. State-Trait Angstinventar. Göttingen: Hogrefe, 1981. Google Scholar
Muthny, FA, Tausch, B. Adaptation der Multidimensional Health Locus of Control Scales (MHLC) für den deutschen Sprachraum [Adaptation of the MHLC for German language]. Zeitschr Diff Diagn Psychol 1994;15: 3–15. Google Scholar
Boyce, P, Gilchrist, J, Talley, NJ, Rose, D. Cognitive-behaviour therapy as a treatment for irritable bowel syndrome: a pilot study. Aust NZ J Psychiatry 2000;34: 300–309. CrossRefGoogle ScholarPubMed