Mindfulness Therapy Aids IBD Patients With Mental Distress

TOPLINE:

Mindfulness-based cognitive therapy reduced psychological distress and improved well-being of patients with inflammatory bowel disease (IBD), and it may offer benefits for sleep quality and inflammation.

METHODOLOGY:

• Even in remission, many patients with IBD experience anxiety, depression, fatigue, and poor sleep, which can lower their quality of life, undermine self-care, and drive up healthcare use.
• Researchers conducted this trial in the Netherlands between July 2021 and May 2022 to strengthen the evidence for the effectiveness of mindfulness-based cognitive therapy in reducing psychological distress in patients with IBD who had been in remission for at least 3 months and experienced at least mild levels of distress.
• They randomly assigned 142 patients (mean age, 48.6 years; 64.1% women) to receive either mindfulness therapy plus usual treatment (n = 70; intervention group) or only usual treatment (n = 72; control group); the follow-up period lasted 12 months.
• The mindfulness therapy program included eight weekly group sessions of 2.5 hours, 30-45 minutes of daily home practice, and a 6-hour silent retreat day between sessions six and seven. Usual treatment included pharmacologic and surgical disease control treatments and the prevention of complications.
• The primary outcome was psychological distress post-intervention (3 months from baseline), measured using the Hospital Anxiety and Depression Scale (HADS) total score. Secondary outcomes included well-being, sleep, self-compassion, mindfulness skills, and disease activity.

TAKEAWAY:

• Patients in the intervention group vs the control group showed reduced psychological distress (Cohen d [d], -0.61) and an improvement in the HADS total score (unstandardized coefficient B, -3.4; P < .001) at 3 months from baseline. The HADS total scores remained lower in the intervention group vs the control group during the entire 12-month follow-up duration.
• Compared with patients in the control group, those in the intervention group showed improved well-being (d, 0.41) and increases in mindfulness skills (d, 0.46) and self-compassion (d, 0.42).
• Patients in the intervention group vs the control group had a reduced total sleep time (d, -0.67) but an increased proportion of deep sleep (d, 0.7).
• No between-group difference was observed in the occurrence of disease flares, but patients in the control group showed a significant reduction in fecal calprotectin levels, an indicator of intestinal inflammation compared with patients in the control group (d, -0.49).

IN PRACTICE:

“Our results demonstrate that MBCT [mindfulness-based cognitive therapy] could be a valuable addition to the currently limited number of psychological treatment options for patients with IBD with psychological distress. The group format of MBCT allows for the simultaneous treatment of more patients, potentially making it more cost-effective than individual therapy. Additionally, group therapy provides opportunities for peer support,” the authors of the study wrote.

SOURCE:

This study, led by Milou M. ter Avest, MD, Department of Psychiatry, Centre for Mindfulness, Radboud University Medical Centre, Nijmegen, the Netherlands, was published online in Inflammatory Bowel Diseases.

LIMITATIONS:

This study was limited by its unblinded design, risking expectation bias in self-reports. Mindfulness teachers had varied competence levels, which may have introduced bias. The study did not assess sleep disorders such as obstructive sleep apnea, narcolepsy, or restless legs syndrome that may have affected the sleep metrics. Additionally, electroencephalography headbands were not available for all patients, and technical and self-application issues may have led to unusable nights and data loss.

DISCLOSURES:

This trial was supported by ZonMw (the Netherlands Organisation for Health Research and Development) and the MindMore Foundation. Two authors reported serving on the advisory boards of various pharmaceutical companies, and one of them also reported receiving a grant from Royal DSM.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.