| Autor: |
Axelsson E; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.; Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden.; Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden., Kern D; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden., Hedman-Lagerlöf E; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden., Lindfors P; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden., Palmgren J; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden., Hesser H; Center for Health and Medical Psychology, School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden.; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden., Andersson E; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden., Johansson R; Department of Psychology, Stockholm University, Stockholm, Sweden., Olén O; Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.; Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.; Department of Pediatric Gastroenterology and Nutrition, Sachs' Children's Hospital, Stockholm, Sweden., Bonnert M; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden., Lalouni M; Division of Neuro, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden., Ljótsson B; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. |
| Abstrakt: |
A wide range of psychological treatments have been found to reduce the symptoms of irritable bowel syndrome (IBS) but their relative effects are unclear. In this systematic review and meta-analysis, we determined the effects of psychological treatments for IBS, including subtypes of cognitive behavior therapy, versus attention controls. We searched 11 databases (March 2022) for studies of psychological treatments for IBS, reported in journal articles, books, dissertations, and conference abstracts. The resulting database comprised 9 outcome domains from 118 studies published in 1983-2022. Using data from 62 studies and 6496 participants, we estimated the effect of treatment type on improvement in composite IBS severity using random-effects meta-regression. In comparison with the attention controls, there was a significant added effect of exposure therapy ( g = 0.52, 95% CI = 0.17-0.88) and hypnotherapy ( g = 0.36, 95% CI = 0.06-0.67) when controlling for the pre- to post-assessment duration. When additional potential confounders were included, exposure therapy but not hypnotherapy retained a significant added effect. Effects were also larger with a longer duration, individual treatment, questionnaire (non-diary) outcomes, and recruitment outside of routine care. Heterogeneity was substantial. Tentatively, exposure therapy appears to be a particularly promising treatment for IBS. More direct comparisons in randomized controlled trials are needed. OSF.io identifier: 5yh9a. |
