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Psychological aspects and psychotherapy of inflammatory bowel diseases and irritable bowel syndrome in children.

Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Czech Republic.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia (Impact Factor: 0.99). 12/2010; 154(4):307-14.
Source: PubMed

ABSTRACT Despite holistic approach to psychosomatic medicine, gastroenterological disorders (GI) tend to be categorized broadly into "functional" and "organic". Major GI illnesses are Inflammatory bowel diseases (IBD) include ulcerative colitis and Crohn's disease. Both are chronic, with remissions and relapses over the years while irritable bowel syndrome (IBS) is a common, often disabling functional gastrointestinal disorder.
A literature review was performed using the National Library of Medicine PubMed database, including all resources within the period 1991-2008, additional references were found through bibliography reviews of relevant articles.
Psychological problems: Higher scores of neuroticism, depression, inhibition, and emotional instability, are typical for many patients with chronic diseases and nonspecific for chronic gastroenterological disorders. Patients with chronic gastrointestinal disorders have impaired health-related quality. Psychological treatments: There have been few adequate psychological treatment trials in IBD. These achieved lower demands for health care rather than a reduction of anxiety or depression. Psychotherapy with chronic gastrointestinal disorders could lead to improve the course of the disease, changing psychological factors such as depression and dysfunctional coping and improving the patient's quality of life.
There seem to be "risk patients" in whom psychosocial components have a bigger influence on the course of disease than in other patients; and those would probably benefit from psychotherapeutic treatment. Psychological treatments help patients manage the psychological distress which worsens bowel symptoms and quality of life.

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    ABSTRACT: Psychological interventions can be effective treatments for patients with medical illnesses such as inflammatory bowel disease (IBD). However, there are barriers to their widespread implementation such as lack of therapists, high costs, stigma, and poor accessibility in remote areas. Computerised psychological interventions can overcome these barriers. The aim of this study was to measure and compare the preferences of IBD patients for computerised versus face-to-face psychological interventions. One hundred and two IBD patients were given a support willingness questionnaire which measured their willingness and confidence to participate in computerised and face-to-face psychological interventions as well as the number of sessions they would be willing to participate in. IBD patients were more likely to want to take part in a computer based than face-to-face intervention (45.5% versus 16.8%, p=0.045). Furthermore, IBD patients were willing to participate in more sessions of computerised than face-to-face intervention median (5 vs. 3.5, Z=3.93, p<0.001). Younger females had a significantly higher acceptability of a computerised intervention than older females (χ(2)(1)=6.77, p=0.009) but the same was not found for males. Duration of disease was not associated with willingness to participate in an intervention. IBD patients appear more willing to participate in a computerised than face-to face psychological intervention. Future studies should attempt to study the effectiveness of computerised psychological interventions in IBD.
    Journal of Crohn s and Colitis 12/2013; · 3.39 Impact Factor
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    ABSTRACT: BACKGROUND: Psychotherapy may be a useful intervention for inflammatory bowel disease (IBD) patients. We systematically reviewed all randomized controlled trials that have been performed in psychotherapy for inflammatory bowel disease patients. METHODS: Systematic searches were undertaken on 1 and 8 March, 2012 of studies of psychotherapy for IBD. RESULTS: Eighteen studies (19 papers) were included in this review. Psychotherapy was found to have minimal effect on measures of anxiety, depression, QOL and disease progression although shows promise in reducing pain, fatigue, relapse rate and hospitalisation, and improving medication adherence. It may also be cost effective. CONCLUSIONS: The effects of psychotherapy on IBD is mixed: future studies should determine whether patient screening or measuring different dependent variables improves outcomes and whether particular psychotherapies are superior over others.
    Journal of Crohn s and Colitis 03/2013; · 3.39 Impact Factor
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    ABSTRACT: Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.
    World Journal of Gastroenterology 04/2014; 20(13):3552-3563. · 2.55 Impact Factor

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