Department of Psychology, Wayne State University, Detroit, MI, USA.
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.
Neurogastroenterol Motil. 2017 Dec;29(12). doi: 10.1111/nmo.13143. Epub 2017 Jun 22.
Current clinical guidelines identify several psychological treatments for irritable bowel syndrome (IBS). IBS patients, however, have elevated trauma, life stress, relationship conflicts, and emotional avoidance, which few therapies directly target. We tested the effects of emotional awareness and expression training (EAET) compared to an evidence-based comparison condition-relaxation training-and a waitlist control condition.
Adults with IBS (N=106; 80% female, Mean age=36 years) were randomized to EAET, relaxation training, or waitlist control. Both EAET and relaxation training were administered in three, weekly, 50-minute, individual sessions. All patients completed the IBS Symptom Severity Scale (primary outcome), IBS Quality of Life, and Brief Symptom Inventory (anxiety, depressive, and hostility symptoms) at pretreatment and at 2 weeks posttreatment and 10 weeks follow-up (primary endpoint).
Compared to waitlist controls, EAET, but not relaxation training, significantly reduced IBS symptom severity at 10-week follow-up. Both EAET and relaxation training improved quality of life at follow-up. Finally, EAET did not reduce psychological symptoms, whereas relaxation training reduced depressive symptoms at follow-up (and anxiety symptoms at posttreatment).
CONCLUSIONS & INFERENCES: Brief emotional awareness and expression training that targeted trauma and emotional conflicts reduced somatic symptoms and improved quality of life in patients with IBS. This emotion-focused approach may be considered an additional treatment option for IBS, although research should compare EAET to a full cognitive-behavioral protocol and determine which patients are best suited for each approach. Registered at clinicaltrials.gov (NCT01886027).
目前的临床指南确定了几种治疗肠易激综合征（IBS）的心理疗法。然而，IBS 患者的创伤、生活压力、人际关系冲突和情绪回避水平较高，而这些问题很少有治疗方法能够直接解决。我们测试了情绪意识和表达训练（EAET）与循证对照条件——放松训练——以及候补对照条件相比的效果。
106 名 IBS 成人患者（80%为女性，平均年龄 36 岁）被随机分为 EAET 组、放松训练组和候补对照组。EAET 和放松训练均在每周三次、每次 50 分钟的个人治疗中进行。所有患者在治疗前、治疗后 2 周和 10 周随访（主要终点）时完成 IBS 症状严重程度量表（主要结局）、IBS 生活质量量表和简明症状量表（焦虑、抑郁和敌对症状）。
与候补对照组相比，EAET 而非放松训练可显著降低 10 周随访时的 IBS 症状严重程度。EAET 和放松训练均可改善生活质量。最后，EAET 并未减轻心理症状，而放松训练则可减轻抑郁症状（且在治疗后减轻焦虑症状）。
针对创伤和情绪冲突的简短情绪意识和表达训练可减轻 IBS 患者的躯体症状并改善其生活质量。这种注重情绪的方法可被视为 IBS 的另一种治疗选择，尽管研究应将 EAET 与完整的认知行为方案进行比较，并确定哪些患者最适合每种方案。在 clinicaltrials.gov 上注册（NCT01886027）。
