Short Term Psychodynamic Psychotherapy in addition to standard medical therapy increases clinical remission in Adolescents and Young Adults with Inflammatory Bowel Disease: a randomised controlled trial
Francesco Milo, Chiara Imondi, Carmen D’Amore, Giulia Angelino, Daniela Knafelz, Fiammetta Bracci, Luigi Dall’Oglio, Paola De Angelis, Paola Tabarini- Gastroenterology
- General Medicine
Abstract
Background
Inflammatory bowel diseases (IBD) are chronic and pervasive conditions of the gastrointestinal tract with a rising incidence in paediatric 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 to SMT alone.
Method
A two-arm single-centre 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 to the control one. The proportion of patients maintaining steroid-free remission at 52 weeks was higher in patients in STTP group (93.1%) compared to patients randomised to control group (64.3%; p = .01). There were no significant differences in secondary outcomes, except for depression reduction in STPP + SMT group.
Conclusions
An 8-week STPP intervention in addition to SMT effectively increases the steroid-free remission rates in AYA with quiescent IBD. Results do not support effects for other secondary outcomes.