Randomized Controlled Trial of Cognitive-Behavioral and Mindfulness-Based Stress Reduction on the Quality of Life of Patients With Crohn Disease

Ganit Goren, Doron Schwartz, Michael Friger, Hagar Banai, Ruslan Sergienko, Shirley Regev, Heba Abu-Kaf, Dan Greenberg, Anna Nemirovsky, Karny Ilan, Livnat Lerner, Alon Monsonego, Iris Dotan, Henit Yanai, Rami Eliakim, Shomron Ben-Horin, Vered Slonim-Nevo, Shmuel Odes, Orly Sarid

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background
Patients with Crohn disease have debilitating psychological symptoms, mental fatigue, and poor quality of life. Psychological intervention may improve these symptoms.
Methods
We performed a randomized parallel-group physician-blinded trial of cognitive-behavioral and mindfulness-based stress reduction (COBMINDEX) on quality of life and psychological symptoms in adults with mild-moderate Crohn disease. COBMINDEX was taught by social workers in one-on-one video conferences over 3 months; quotidian home practice was mandated.

Results
Fifty-five COBMINDEX and 61 waitlist control patients completed the study; mean age was 33 years and 65% of participants were women. At 3 months, COBMINDEX patients had significantly reduced disease activity (per Harvey-Bradshaw Index score, C-reactive protein level, and calprotectin level), increased quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ] score increased from baseline 41 to 50; P < 0.001), decreased psychological symptoms (Global Severity Index [GSI], 0.98-0.70; P < 0.001), reduced fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue, 26-33; P < 0.001), and increased mindfulness disposition (Freiburg Mindfulness Inventory, 33-38; P < 0.001). Waitlist patients had a significant but small change in Harvey-Bradshaw Index, SIBDQ, and GSI scores, without improvement in fatigue or mindfulness. There were significant correlations (0.02 > P < 0.002) in COBMINDEX patients between baseline SIBDQ, GSI, Freiburg Mindfulness Inventory, and Functional Assessment of Chronic Illness Therapy-Fatigue scores with a relative change (baseline to 3 months) of the SIBDQ score, but none among waitlist patients. Predictors of relative change of the SIBDQ score in COBMINDEX patients included the GSI score (90% quantile; coefficient 0.52; P < 0.001), somatization (90%; 0.20; P = 0.001), depression (75%; 0.16; P = 0.03), and phobic anxiety (75%; 0.31; P = 0.008).
Conclusions
COBMINDEX was effective in increasing patients’ quality of life and reducing psychological symptoms and fatigue. Patients with severe baseline psychological symptoms benefited the most from COBMINDEX.
Original languageEnglish GB
Pages (from-to)1-16
Number of pages16
JournalInflammatory Bowel Diseases
VolumeXX
Issue number3
DOIs
StatePublished - 15 Mar 2021

Keywords

  • depression
  • fatigue
  • inflammatory bowel disease
  • psychological intervention
  • somatization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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