A Critical Review of Cognitive, Behavioral, and Cognitive-Behavioral Therapies for Irritable Bowel Syndrome

Abstract

Research on controlled evaluations of psychological treatments for IBS is summarized with regards to methodology and outcome, with special attention to differential outcome. There is ample evidence to support the efficacy of various combinations of cognitive and behavioral therapy techniques as well as brief psychodynamic psychotherapy, and hypnotherapy. There has also recently appeared some evidence that is not supportive of each approach. Long-term follow-up, although relatively rare, generally finds the maintenance of initial improvement in IBS symptoms. There is some growing evidence on changes in the putative cognitive mechanisms targeted by the cognitive therapy techniques. More research is needed on these process variables. The field may be ripe for direct comparisons of 2 or more psychological approaches to the IBS treatment.