Cognitive behavior therapy (CBT) is an empirically validated treatment for irritable bowel syndrome (IBS), yet it is unclear for whom and under what circumstances it is most effective.
Dr Jeffrey Lackner and colleagues from New York, USA investigated whether patients who achieved a positive response soon after cognitive behavior therapy onset termed rapid responders, maintain treatment gains compared with non–rapid responders.
The research team also characterized the psychosocial profile of rapid responders on clinically relevant variables.
The researchers included 71 individuals whose irritable bowel syndrome, symptoms were consistent with Rome II criteria and were of at least moderate severity.
|Treatment with CBT gives a positive response within 4 weeks|
|Clinical Gastroenterology & Hepatology|
Patients were assigned randomly to undergo a wait list control.
The team reported patients received 10 weekly 1-hour sessions of cognitive behavior therapy, or 4 1-hour cognitive behavior therapy sessions over 10 weeks.
Rapid responders were classified as patients who reported adequate relief of pain, adequate relief of bowel symptoms, and decrease in total irritable bowel syndrome severity scores of 50 or greater by week 4.
The team found that of patients undergoing cognitive behavior therapy, 30% were rapid responders.
The team observed that 90% to 95% of the rapid responders maintained gains at the immediate and 3-month follow-up examinations.
Although the rapid responders reported more severe irritable bowel syndrome symptoms at baseline, they achieved more substantial, sustained irritable bowel syndrome symptom reduction than non–rapid responders.
Both dosages of cognitive behavior therapy had comparable rates of rapid responder.
Dr Lackner's team concluded, “A significant proportion of irritable bowel syndrome patients treated with cognitive behavior therapy have a positive response within 4 weeks of treatment.”
“These patients are more likely to maintain treatment gains than patients without a rapid response.”
“A rapid response is not contingent on the amount of face-to-face contact with a clinician.”