Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
J Psychosom Res. 2013 Aug;75(2):103-12. doi: 10.1016/j.jpsychores.2013.05.007. Epub 2013 Jun 10.
Psychological treatments are effective in alleviating symptoms of IBS but are not widely available. The need for wider dissemination of treatments has encouraged the development of 'minimal-contact' therapies requiring fewer resources than existing psychological treatments which rely on face-to-face contact.
Using comprehensive search terms, the Embase, Medline and PsychInfo databases (all years) were searched.
Twelve studies--nine RCTs and three non-controlled preliminary studies - meeting inclusion criteria were reviewed and assessed for quality using objective criteria. Apart from one study of expressive writing, all interventions were based on cognitive (and/or) behavioural principles or hypnosis and tended to be adaptations of existing therapist-led interventions. Compared to control conditions, minimal-contact interventions were efficacious, the majority of studies showing statistically significant improvements by the end of treatment. For cognitive-behaviour-therapy-based interventions effects sizes were large. The two studies that compared minimal-contact with therapist-delivered interventions broadly suggest comparable outcomes between these modalities.
Minimal-contact cognitive-behavioural interventions show promise in the treatment of IBS. Because of the lower quality of studies of hypnosis and those involving interventions delivered entirely remotely, further support is needed before such approaches can be recommended for widespread use. More generally, future research should use representative samples, active control conditions, and intention to treat analysis. Nonetheless, existing high quality studies suggest that minimal-contact therapies may be a safe, effective means of achieving scaleability of psychological treatments for IBS.
心理治疗可有效缓解 IBS 症状，但并未广泛应用。为了更广泛地推广治疗方法，人们开发了“低接触”疗法，与依赖于面对面接触的现有心理治疗相比，这些疗法所需资源更少。
使用全面的检索词，检索了 Embase、Medline 和 PsychInfo 数据库（所有年份）。
共纳入了 12 项研究——9 项 RCT 和 3 项非对照初步研究，并使用客观标准对这些研究进行了质量评估。除了一项表达性写作研究外，所有干预措施均基于认知（和/或）行为原则或催眠，并且倾向于对现有的治疗师主导的干预措施进行改编。与对照组相比，低接触干预措施有效，大多数研究在治疗结束时显示出统计学上显著的改善。基于认知行为疗法的干预措施的效果大小较大。比较低接触与治疗师提供的干预措施的两项研究表明，这两种方法的结果大致相似。
低接触认知行为干预措施在 IBS 的治疗中显示出了希望。由于催眠和完全远程干预措施研究的质量较低，因此在广泛推荐这些方法之前，还需要进一步的支持。更一般地说，未来的研究应该使用代表性样本、积极的对照条件和意向治疗分析。尽管如此，现有的高质量研究表明，低接触疗法可能是实现 IBS 心理治疗可扩展性的一种安全、有效的方法。
