A randomized controlled trial of psychotherapy in patients with chronic functional dyspepsia

Gastroenterology. 2000 Sep;119(3):661-9. doi: 10.1053/gast.2000.16493.


Background & aims: This study aimed to determine whether brief psychodynamic-interpersonal (PI) psychotherapy is more efficacious than a psychological control for patients with chronic, intractable functional dyspepsia (FD), and whether patients with abnormal gastric function respond differently than those with normal gastric function.

Methods: Ninety-five consecutive patients with chronic symptoms of FD who had failed to respond to conventional pharmacologic treatments were approached. Thirty-seven received PI psychotherapy, and 36 the control condition (supportive therapy). Patients completed self-report questionnaires before and after treatment and 12 months later. The patients' gastroenterologists, who were blind to the study groups, conducted independent ratings before and after treatment. Forty-nine patients also underwent a radioisotope gastric emptying study. An intention-to-treat analysis was used with baseline scores as covariates.

Results: At the end of treatment, there were significant advantages for PI psychotherapy compared with controls for the gastroenterologists' (P = 0.002) and patients' total symptom score (P = 0.015). One year after treatment, the symptomatic scores were similar. However, a subanalysis showed that PI therapy was superior to the control condition at 1 year, when patients with severe heartburn were excluded. There was no difference in outcome between patients with normal and abnormal gastric emptying.

Conclusions: PI therapy may have both short- and long-term effects in patients with dyspepsia, but further evaluation is required. Its cost-effectiveness needs to be determined.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Dyspepsia / physiopathology
  • Dyspepsia / psychology
  • Dyspepsia / therapy*
  • Female
  • Gastric Emptying
  • Gastroenterology / methods
  • Health Services / statistics & numerical data
  • Health Status
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Psychotherapy*
  • Single-Blind Method
  • Surveys and Questionnaires
  • Time Factors