Short-term and Long-term Efficacy of Psychological Therapiesfor Irritable Bowel Syndrome: A Systematic Reviewand Meta-analysis.

Abstract

Several meta-analyses have demonstrated the efficacy of psychological therapies for reducing gastrointestinal (GI) symptoms in patients with irritable bowel syndrome (IBS). However, no meta-analysis has investigated the duration of these effects. We performed a meta-analysis to assess the immediate, short-term, and long-term efficacy of psychotherapy for reducing GI symptoms in adults with IBS. We searched PubMed, PsycINFO, Science Direct, and ProQuest Dissertations and Theses through August 15, 2015 for randomized controlled trials that compared psychological therapy with an active or non-active comparison (control) condition for treatment of GI symptoms in adults with IBS. Forty-one trials were included in our meta-analysis, comprising data from 2290 individuals(1183 assigned to psychotherapy and 1107 assigned to a control condition). Compared with a mixed group of control conditions, psychological therapies had a medium effect on GIsymptom severity (d¯= 0.69) immediately after treatment. On average, individuals whoreceived psychotherapy had a greater reduction in GI symptoms after treatment than 75% of individuals assigned to a control condition. After short-term follow-up periods (1-6months after treatment) and long-term follow-up periods (6-12 months after treatment), this effect remained significant and medium in magnitude (d¯= 0.76 and d¯= 0.73, respectively). Psychological therapies reduce GI symptoms in adults with IBS. These effects remained significant and medium in magnitude after short-term and long-term follow-up periods.