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Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, which severely impairs the quality of life of patients. Treatment of refractory IBS patients is needed, but it is not yet widely available. Therefore, we previously developed a Japanese version of cognitive behavioral therapy...

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Autores principales: Funaba, Misako, Kawanishi, Hitomi, Fujii, Yasushi, Higami, Koyo, Tomita, Yoshitoshi, Maruo, Kazushi, Sugawara, Norio, Oe, Yuki, Kura, Satsuki, Horikoshi, Masaru, Ohara, Chisato, Kikuchi, Hiroe, Ariga, Hajime, Fukudo, Shin, Sekiguchi, Atsushi, Ando, Tetsuya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458884/
https://www.ncbi.nlm.nih.gov/pubmed/34566709
http://dx.doi.org/10.3389/fpsyt.2021.673939
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author Funaba, Misako
Kawanishi, Hitomi
Fujii, Yasushi
Higami, Koyo
Tomita, Yoshitoshi
Maruo, Kazushi
Sugawara, Norio
Oe, Yuki
Kura, Satsuki
Horikoshi, Masaru
Ohara, Chisato
Kikuchi, Hiroe
Ariga, Hajime
Fukudo, Shin
Sekiguchi, Atsushi
Ando, Tetsuya
author_facet Funaba, Misako
Kawanishi, Hitomi
Fujii, Yasushi
Higami, Koyo
Tomita, Yoshitoshi
Maruo, Kazushi
Sugawara, Norio
Oe, Yuki
Kura, Satsuki
Horikoshi, Masaru
Ohara, Chisato
Kikuchi, Hiroe
Ariga, Hajime
Fukudo, Shin
Sekiguchi, Atsushi
Ando, Tetsuya
author_sort Funaba, Misako
collection PubMed
description Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, which severely impairs the quality of life of patients. Treatment of refractory IBS patients is needed, but it is not yet widely available. Therefore, we previously developed a Japanese version of cognitive behavioral therapy with interoceptive exposure (CBT-IE) involving 10 face-to-face sessions to treat refractory IBS patients. To disseminate this treatment of IBS in places where therapists are limited, we further developed a hybrid CBT-IE program with complementary video materials that include psychoeducation and homework instructions so that patients can prepare for face-to-face sessions in advance at home and the session time can be shortened, thereby reducing the burden on both patient and therapist. In this study, we conducted a trial to evaluate the feasibility, efficacy, and safety of the hybrid CBT-IE program for Japanese IBS patients. The study was a single-arm, open-label pilot clinical trial. A total of 16 IBS patients were included in the study and 14 patients completed the intervention, which consisted of 10 weekly individual hybrid CBT-IE sessions. We performed an intention to treat analysis. The primary outcome measure for the efficacy of the intervention was a decrease in the severity of IBS symptoms. The feasibility and safety of the intervention were examined by the dropout rate and recording of adverse events, respectively. The dropout rate of the hybrid CBT-IE was comparable to that of our previous CBT-IE with only face-to-face sessions and no adverse events were recorded. The severity of IBS symptoms within-group was significantly decreased from the baseline to mid-treatment [Hedges' g = −0.98 (−1.54, −0.41)], post-treatment [Hedges' g = −1.48 (−2.09, −0.88)], 3-month follow-up [Hedges' g = −1.78 (−2.41, −1.14)], and 6-month follow-up [Hedges' g = −1.76 (−2.39, −1.13)]. Our results suggest that the hybrid CBT-IE is effective and could be conducted safely. To confirm the effectiveness of the hybrid CBT-IE, it is necessary to conduct a multicenter, parallel-design randomized control trial. Clinical Trial Registration: [https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041376], identifier [UMIN000036327].
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spelling pubmed-84588842021-09-24 Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study Funaba, Misako Kawanishi, Hitomi Fujii, Yasushi Higami, Koyo Tomita, Yoshitoshi Maruo, Kazushi Sugawara, Norio Oe, Yuki Kura, Satsuki Horikoshi, Masaru Ohara, Chisato Kikuchi, Hiroe Ariga, Hajime Fukudo, Shin Sekiguchi, Atsushi Ando, Tetsuya Front Psychiatry Psychiatry Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, which severely impairs the quality of life of patients. Treatment of refractory IBS patients is needed, but it is not yet widely available. Therefore, we previously developed a Japanese version of cognitive behavioral therapy with interoceptive exposure (CBT-IE) involving 10 face-to-face sessions to treat refractory IBS patients. To disseminate this treatment of IBS in places where therapists are limited, we further developed a hybrid CBT-IE program with complementary video materials that include psychoeducation and homework instructions so that patients can prepare for face-to-face sessions in advance at home and the session time can be shortened, thereby reducing the burden on both patient and therapist. In this study, we conducted a trial to evaluate the feasibility, efficacy, and safety of the hybrid CBT-IE program for Japanese IBS patients. The study was a single-arm, open-label pilot clinical trial. A total of 16 IBS patients were included in the study and 14 patients completed the intervention, which consisted of 10 weekly individual hybrid CBT-IE sessions. We performed an intention to treat analysis. The primary outcome measure for the efficacy of the intervention was a decrease in the severity of IBS symptoms. The feasibility and safety of the intervention were examined by the dropout rate and recording of adverse events, respectively. The dropout rate of the hybrid CBT-IE was comparable to that of our previous CBT-IE with only face-to-face sessions and no adverse events were recorded. The severity of IBS symptoms within-group was significantly decreased from the baseline to mid-treatment [Hedges' g = −0.98 (−1.54, −0.41)], post-treatment [Hedges' g = −1.48 (−2.09, −0.88)], 3-month follow-up [Hedges' g = −1.78 (−2.41, −1.14)], and 6-month follow-up [Hedges' g = −1.76 (−2.39, −1.13)]. Our results suggest that the hybrid CBT-IE is effective and could be conducted safely. To confirm the effectiveness of the hybrid CBT-IE, it is necessary to conduct a multicenter, parallel-design randomized control trial. Clinical Trial Registration: [https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041376], identifier [UMIN000036327]. Frontiers Media S.A. 2021-09-09 /pmc/articles/PMC8458884/ /pubmed/34566709 http://dx.doi.org/10.3389/fpsyt.2021.673939 Text en Copyright © 2021 Funaba, Kawanishi, Fujii, Higami, Tomita, Maruo, Sugawara, Oe, Kura, Horikoshi, Ohara, Kikuchi, Ariga, Fukudo, Sekiguchi and Ando. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Funaba, Misako
Kawanishi, Hitomi
Fujii, Yasushi
Higami, Koyo
Tomita, Yoshitoshi
Maruo, Kazushi
Sugawara, Norio
Oe, Yuki
Kura, Satsuki
Horikoshi, Masaru
Ohara, Chisato
Kikuchi, Hiroe
Ariga, Hajime
Fukudo, Shin
Sekiguchi, Atsushi
Ando, Tetsuya
Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
title Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
title_full Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
title_fullStr Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
title_full_unstemmed Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
title_short Hybrid Cognitive Behavioral Therapy With Interoceptive Exposure for Irritable Bowel Syndrome: A Feasibility Study
title_sort hybrid cognitive behavioral therapy with interoceptive exposure for irritable bowel syndrome: a feasibility study
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458884/
https://www.ncbi.nlm.nih.gov/pubmed/34566709
http://dx.doi.org/10.3389/fpsyt.2021.673939
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