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Do Symptoms of Irritable Bowel Syndrome Improve when Patients Receive Cognitive Behavioural Therapy for Co-morbid Anxiety Disorders in a Primary Care Psychological Therapy (IAPT) Service?

Published online by Cambridge University Press:  08 May 2017

Mark Kenwright ,
Jason McDonald ,
Jo Talbot  and
Kinza Janjua
Mark Kenwright*
Affiliation:
South Staffordshire and Shropshire NHS Foundation Trust
Jason McDonald
Affiliation:
North Staffordshire Combined Healthcare NHS Trust
Jo Talbot
Affiliation:
Mental Health Matters
Kinza Janjua
Affiliation:
Mental Health Matters
*
Correspondence to South Staffordshire and Shropshire Healthcare NHS Foundation Trust, North Staffordshire Wellbeing Service, Eaton House, Buxton Road, Stafford, United Kingdom of Great Britain and Northern Ireland, ST16 3SR E-mail: mark.kenwright@northstaffs.nhs.uk
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Abstract

Background: Irritable bowel syndrome (IBS) is a common co-morbid condition with anxiety disorders, and patients often report a fear of incontinence in public places. This type of bowel control anxiety (BCA) can be conceptualized as a phobic syndrome. Yet little evidence exists on the prevalence or outcomes of these co-morbidities in routine primary care psychological therapy (Improving Access to Psychological Therapies, IAPT) services. Aims: To examine the prevalence and outcomes of IBS and BCA patients treated with cognitive behavioural therapy (CBT) for anxiety disorders within a routine IAPT service. Method: An observational cohort study screened 2322 referrals to an IAPT service over 12 months for the presence of IBS. Patients with co-morbid anxiety disorders and IBS were grouped into those with, and without BCA. Patients completed the IBS symptom severity scale and the IAPT minimum data set. Diagnoses and outcomes were examined for all groups up to 6 months follow-up. Results: A greater proportion of BCA patients had a primary diagnosis of phobic disorder. After receiving CBT, patients made clinically significant improvement in both anxiety and IBS symptoms at 6 months follow-up. Patients with BCA made greater improvement in phobia scales and IBS symptoms than non-BCA patients. Conclusions: Anxiety disorders with co-morbid IBS improved significantly in a routine IAPT service. A significant proportion of co-morbid IBS sufferers had a fear of incontinence in public places (BCA). Directly addressing and modifying these fears with CBT appeared to enhance improvement in both phobic anxiety and IBS symptoms.

Keywords

Irritable bowel syndromebowel control anxietyIAPT
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 5 , September 2017 , pp. 433 - 447
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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