IBD-Specific Cognitive Behavioral Therapy: Sustainability of Effect After Three Years

Background and Aims: ‘Inflammatory Bowel Disease (IBD)-specific-Cognitive-Behavioral Therapy’ (CBT) is effective in improving Quality of Life (QoL) and in decreasing anxiety and depression in IBD-patients with poor mental QoL, one month after completing CBT. Main aim was to examine the sustainability of treatment effects up to three years after treatment with CBT. 

Method: Participants (n = 118) of a previously conducted randomized-control-study on the effects of ‘IBD-specific-CBT’ for IBD-patients were contacted for a long-term follow-up assessment on main outcomes: generic and IBD-specific-QoL (SF-36, IBDQ), anxiety and depression (HADS, CES-D) and DSM-IV disorders (SCID-I). Change over time was examined with multilevel-regression-analyses. 

Results: Three years after finishing ‘IBD-specific-CBT’, 61 IBD-patients (response rate 52%) completed the follow-up SCID-I assessment and 52 patients (response rate 44%) completed the assessments for symptomatology. There were no differences between dropouts and participants at three year follow-up, except for a longer disease duration in dropouts. At three-year follow-up the chance of patients having a DSM-disorder significantly decreased with an estimated 48% (from 87% at baseline to 38% at follow-up). Multilevel analyses showed a significant improvement between baseline (n = 118) and follow-up measurements (n = 52) on outcomes: IBDQ-Total (Cohen’s d effect-size = .89), SF-36 Physical (d = .54), and SF-36 Mental (d = .69), HADS-A (d = -.77), HADS-D (d = -.65) and CES-D (d = -.55); all p < .01. QoL outcomes showed further improvement between completion (n = 90 for IBD-specific QoL and n = 91 for generic QoL) and follow-up measurements, with significant improvements for IBDQ-Total (d = 0.31) and SF-36 Physical (d = 0.32). 

Conclusions: Sustainable positive effects of ‘IBD-specific-CBT’ for IBD-patients with poor mental QoL were found and the prevalence of mental conditions substantially decreased over three year follow-up.