Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial

IF 3.5 2区医学 Q2 PSYCHIATRY Journal of Psychosomatic Research Pub Date : 2024-10-11 DOI:10.1016/j.jpsychores.2024.111949

Quirine M. Bredero , Joke Fleer , Ans Smink , Greetje Kuiken , Joke Potjewijd , Marleen Laroy , Marijn C. Visschedijk , Maurice Russel , Mark van der Lugt , Maarten A.C. Meijssen , Egbert Jan van der Wouden , Gerard Dijkstra , Maya J. Schroevers

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Abstract

Objectives

Fatigue is prevalent in patients with inflammatory bowel disease (IBD) in remission. Previously, we showed that fatigued IBD patients experienced a significant decrease in fatigue after receiving mindfulness-based cognitive therapy (MBCT). The current study examined to what extent these short-term beneficial effects of MBCT on fatigue were maintained over nine months follow-up, and whether patient characteristics were associated with clinically relevant improvement in fatigue.

Methods

A randomized controlled trial, including an MBCT and waiting-list control condition, was performed in fatigued IBD patients in remission. For this study, we analysed long-term outcomes of 108 patients who received MBCT (either directly or after three months waiting). The primary outcome was fatigue, assessed with the Checklist Individual Strenght-20. Secondary outcomes included fatigue interference, depression, anxiety, and quality of life.

Results

The reduced level of fatigue post-treatment did not change significantly during follow-up (F(2,76) = 1.68, p = 0.19). In total, 29% of patients reported clinically relevant improvement from pre-treatment to nine months follow-up. We found few significant differences in baseline characteristics between those reporting clinically relevant improvement and those not, except that patients who improved were significantly more often unemployed (χ²(1, n = 73) = 4.40, p = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up.

Conclusion

Findings suggest that reductions in IBD-related fatigue after receiving MBCT are sustained over nine months follow-up, with around one-third of patients reporting clinically relevant improvement from pre-treatment to follow-up. Employment status might be related to improvements in fatigue. Future research is needed to confirm these long-term outcomes.

Preregistration

ClinicalTrials.gov ID: NCT03162575.

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基于正念的认知疗法对炎症性肠病患者疲劳的长期治疗效果：随机对照试验的结果

目的缓解期炎症性肠病（IBD）患者普遍感到疲劳。此前，我们的研究表明，疲劳的 IBD 患者在接受正念认知疗法（MBCT）治疗后，疲劳感明显减轻。目前的研究考察了 MBCT 对疲劳的短期有益影响在九个月的随访中的维持程度，以及患者的特征是否与疲劳的临床相关改善有关。方法对缓解期的疲劳 IBD 患者进行了随机对照试验，包括 MBCT 和等待名单对照条件。在这项研究中，我们分析了 108 名接受 MBCT（直接或等待三个月后）治疗的患者的长期疗效。主要结果是疲劳，用《个人力量检查表-20》进行评估。次要结果包括疲劳干扰、抑郁、焦虑和生活质量。结果治疗后疲劳程度的降低在随访期间没有显著变化（F(2,76) = 1.68, p = 0.19）。从治疗前到九个月的随访期间，总共有 29% 的患者报告了临床相关的改善。我们发现，报告临床相关改善和未报告临床相关改善的患者在基线特征方面几乎没有明显差异，但改善的患者失业率明显更高（χ2(1, n = 73) = 4.40, p = 0.04）。结论研究结果表明，接受 MBCT 治疗后，与 IBD 相关的疲劳症状会在九个月的随访中持续减轻，约有三分之一的患者报告从治疗前到随访期间出现了临床相关的改善。就业状况可能与疲劳的改善有关。未来的研究需要证实这些长期结果：NCT03162575。

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.