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Can IBS (irritable bowel syndrome) be conceptualized as an anxiety disorder and what treatment implications would that have?

Published online by Cambridge University Press:  16 April 2020

B. Ljotsson
Affiliation:
Department of Research and Development, Psychiatry Centre Karolinska, Stockholm, Sweden
S. Andreewitch
Affiliation:
Anxiety Programme, Psychiatry Centre Karolinska, Stockholm, Sweden

Abstract

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Background and aims:

IBS is a heterogeneous condition of unknown etiology. With a one-year prevalence above 10%, it is second only to common cold in terms of causes for work absenteeism.

An association of psychiatric disturbance and the gastrointestinal system is well established:

  1. Psychiatric comorbidity, mainly anxiety and depression, is common.

  2. In what is known as the Brain-gut axis, noxious stimulation to the gut activates parts of the central nervous system involved in fear and arousal.

  3. Negative evaluation of symptoms has been shown to predict the amount of worry about symptoms that patients experience

  4. Patients with IBS frequently display abnormal illness behaviors, such as excessive requests for medical help.

This suggests that IBS can conceptualized as a disorder in which negative evaluation of bodily symptoms increases intensity, frequency, and duration of symptoms. Trials of CBT for IBS have been conducted, but few studies have evaluated group treatment. Since treatment-needs presently cannot be met, more cost-effective ways of delivering CBT for IBS are needed.

Methods:

We are currently conducting a pilot study of group-delivered manualized CBT for 19 IBS-patients.

Results:

Treatment is ongoing, and results from the first 9 patients taking part in the treatment will be presented as single case studies. For a subgroup of patients, 6-month follow up data will be available.

Conclusions:

Preliminary post-treatment data suggest that group-delivered CBT may be feasible for this group. Experiences from this trial will be used in a larger study comparing group treatment to web-based treatment, further utilizing scarce CBT resources.

Type
Poster Session 2: Anxiety, Stress Related, Impulse and Somatoform Disorders
Copyright
Copyright © European Psychiatric Association 2007
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