Colon to Rectum
J Crohns Colitis. 2024;18(2):256–63
Short-term psychodynamic psychotherapy in addition to standard medical therapy increases clinical remission in adolescents and young adults with inflammatory bowel disease: A randomized controlled trial
Background: Inflammatory bowel diseases (IBD) are chronic and pervasive conditions of the gastrointestinal tract with a rising incidence in pediatric and young adult populations. Evidence suggests that psychological disorders might be associated with relapse of disease activity. This study aims to evaluate the efficacy of short-term psychodynamic psychotherapy (STPP) in addition to standard medical therapy (SMT) in maintaining clinical remission in adolescents and young adults (AYA) with quiescent IBD, compared with SMT alone.
Methods: A 2-arm, single-center, randomized, controlled trial was conducted in 60 IBD AYA in clinical remission. Patients were randomized to receive an 8-week STPP+SMT (n = 30) or SMT alone (n = 30). The primary outcome was the steroid-free remission rate at 52 weeks after treatment. Secondary outcomes included the overall hospitalization rate within 52 weeks after treatment, and medication adherence obtained from patient’s electronic medical records.
Results: Intention-to-treat analysis showed significant improvement in maintaining disease remission rates in the 8-week STPP+SMT group compared with the control group. The proportion of patients maintaining steroid-free remission at 52 weeks was higher in patients in the STPP+SMT group (93.1%) compared with patients randomized to the control group (64.3%; p = 0.01). There were no significant differences in secondary outcomes, except for depression reduction in the STPP+SMT group.
Conclusions: An 8-week short-term psychodynamic psychotherapy intervention in addition to standard medical therapy effectively increases the steroid-free remission rates in adolescents and young adults with quiescent inflammatory bowel disease. Results do not support effects for other secondary outcomes, except for depression reduction.