Intervening on cognitions and behavior in irritable bowel syndrome: A feasibility trial using PDAs

J Psychosom Res. 2011 Mar;70(3):267-77. doi: 10.1016/j.jpsychores.2010.09.018. Epub 2010 Dec 15.

Abstract

Objective: Irritable bowel syndrome (IBS) is a common, chronic, and often disabling disorder. Cognitive-behavioral therapy (CBT) has been shown to be effective in alleviating IBS symptoms. The aim of this study was to establish the feasibility and the efficacy of a cognitive-behavioral e-intervention using personal digital assistants (PDAs) on the self-management of IBS patients.

Methods: A feasibility trial was conducted with 38 control group patients receiving standard care and 37 intervention group patients receiving standard care supplemented with a 4-week CBT intervention on PDAs. All patients fulfilled the diagnostic Rome III criteria for IBS. At baseline, 4-week, and 3-month follow-up, patients' abdominal pain, dysfunctional cognitions, IBS quality of life, and pain catastrophizing thoughts were assessed using written questionnaires.

Results: Between-group comparisons between baseline and 4 weeks showed more overall quality of life improvement, more improvement in catastrophizing thoughts, and more pain improvement in the intervention group. Only improvement in catastrophizing thoughts persisted in the long-term. No significant differences between groups were found for dysfunctional cognitions. As all 37 intervention group patients completed the intervention and completed diaries three times a day for 4 weeks, the e-health intervention seems feasible.

Conclusions: A cognitive-behavioral intervention on pocket-type computers appears feasible and efficacious for improving IBS-related complaints and cognitions in the short-term. The intervention group improved on several aspects, but most on catastrophizing thoughts, and these improvements even persisted after 3 months. Future studies should focus on unravelling the effective components of this innovative e-health intervention.

Publication types

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

MeSH terms

  • Adult
  • Analysis of Variance
  • Behavior Therapy / instrumentation*
  • Catastrophization / psychology*
  • Computers, Handheld*
  • Feasibility Studies
  • Female
  • Humans
  • Irritable Bowel Syndrome / psychology*
  • Irritable Bowel Syndrome / therapy
  • Male
  • Middle Aged
  • Pain / psychology*
  • Pain Management
  • Pain Measurement / psychology
  • Quality of Life / psychology*
  • Self Care
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome