Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2005 Aug 20;331(7514):435.
doi: 10.1136/bmj.38545.505764.06. Epub 2005 Aug 10.

Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial

Tom Kennedy  1 , Roger Jones, Simon Darnley, Paul Seed, Simon Wessely, Trudie Chalder
Affiliations
Clinical Trial

Cognitive behaviour therapy in addition to antispasmodic treatment for irritable bowel syndrome in primary care: randomised controlled trial

Tom Kennedy et al. BMJ. .

Abstract

Objective: To assess the efficacy of cognitive behaviour therapy delivered in primary care for treating irritable bowel syndrome.

Design: Randomised controlled trial.

Setting: 10 general practices in London.

Participants: 149 patients with moderate or severe irritable bowel syndrome resistant to the antispasmodic mebeverine.

Interventions: Cognitive behaviour therapy delivered by trained primary care nurses plus 270 mg mebeverine taken thrice daily compared with mebeverine treatment alone.

Main outcome measures: Primary measures were patients' scores on the irritable bowel syndrome symptom severity scale. Secondary measures were scores on the work and social adjustment scale and the hospital anxiety and depression scale.

Results: Of 334 referred patients, 72 were randomised to mebeverine plus cognitive behaviour therapy and 77 to mebeverine alone. Cognitive behaviour therapy had considerable initial benefit on symptom severity compared with mebeverine alone, with a mean reduction in score of 68 points (95% confidence interval 103 to 33), with the benefit persisting at three months and six months after therapy (mean reductions 71 points (109 to 32) and 11 points (20 to 3)) but not later. Cognitive behaviour therapy also showed significant benefit on the work and social adjustment scale that was still present 12 months after therapy (mean reduction 2.8 points (5.2 to 0.4)), but had an inconsistent effect on the hospital anxiety and depression scale.

Conclusion: Cognitive behaviour therapy delivered by primary care nurses offered additional benefit over mebeverine alone up to six months, although the effect had waned by 12 months. Such therapy may be useful for certain patients with irritable bowel syndrome in primary care.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Patient flow through study
Fig 2
Fig 2
Mean (95% confidence interval) scores on irritable bowel symptom severity scale (SSS) for 149 patients, by treatment
Fig 3
Fig 3
Mean (95% confidence interval) scores on work and social adjustment (WASA) scale for 149 patients with irritable bowel syndrome, by treatment
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Talley NJ, Spiller R. Irritable bowel syndrome: a little understood organic bowel disease? Lancet 2002;360; 555-64. - PubMed
    1. Owens DM, Nelson DK, Talley NJ. The irritable bowel syndrome: long term prognosis and the physician-patient interaction. Ann Intern Med 1995;122: 107-12. - PubMed
    1. Manning AP, Thompson WG, Heaton KW, Morris AF. Towards a positive diagnosis of the irritable bowel. BMJ 1978;ii: 653-4. - PMC - PubMed
    1. Thompson WG, Dotevall G, Drossman DA. Irritable bowel syndrome: guidelines for diagnosis. Gastroenterol Int 1989;2: 92-5.
    1. Drossman DA, Thompson WG, Talley NJ, Funch-Jensen P, Janssens J, Whitehead WE. Identification of sub-groups of functional gastrointestinal disorders. Gastroenterol Int 1990;3: 159-72.

Publication types