# Cognitive-behavioral treatment of irritable bowel syndrome



## Jeffrey Roberts (Apr 15, 1987)

CNS Spectr. 2005 Nov;10(11):883-90.Cognitive-behavioral treatment of irritable bowel syndrome.Toner BB.Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.There is increasing evidence that supports the view that irritable bowel disorder (IBS) is a disorder of brain-gut function. Cognitive-behavioral therapy (CBT) has received increased attention in light of this recent shift in the conceptualization of IBS. This review has two main aims. The first is to provide a critical review of controlled trials on CBT for IBS. The second is to discuss ways of further developing CBT interventions that are more clinically relevant and meaningful to health care providers and individuals with a diagnosis of IBS. A theme from a CBT intervention will be presented to illustrate how CBT interventions can be incorporated within a larger social context. A review of CBT for IBS lends some limited support for improvement in some IBS symptoms and associated psychosocial distress. This conclusion needs to be expressed with some caution, however, in light of many methodological shortcomings including small sample sizes, inadequate control conditions and failure to identify primary versus secondary outcome measures. In addition, future studies will need to further develop more relevant CBT protocols that more fully integrate the patient's perspective and challenge social cognitions about this stigmatized disorder.PMID: 16273018http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=16273018


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## Jeffrey Roberts (Apr 15, 1987)

CNS Spectr. 2005 Nov;10(11):883-90.Cognitive-behavioral treatment of irritable bowel syndrome.Olden KW.Division of Gastroenterology, University of South Alabama, Mobile, Mobile, AL, USA.Since their introduction 50 years ago, antidepressants have been used in a wide variety of settings involving gastrointestinal (GI) disease. In the 1950s, antidepressants were shown to have some efficacy for the treatment of peptic ulcer disease. This is most likely due to their antihistaminic and anticholinergic effects. Since then, more efficacious and more disease-specific treatments have become available. In the last 20 years, antidepressants have been increasingly used for the treatment of functional gastrointestinal disorders such as irritable bowel syndrome, noncardiac chest pain, and other functional GI disorders. This article will review the rationale for the use of antidepressant drugs for the treatment of functional GI disorders. The role of psychiatric comorbidity in functional GI disorders, the impact of antidepressants on GI motility and visceral sensation, and the ability of these agents to produce improvements in the global well-being and overall quality of life will be reviewed. Finally, guidelines for prescribing and barriers to a patient's acceptance of these agents will be discussed.PMID: 16273017http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=16273017


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