Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany.
Philipps-Universität Marburg, Department of Clinical Psychology and Psychotherapy, 35037 Marburg, Germany; Health and Medical University, Medical Psychology, 99084 Erfurt, Germany.
J Psychosom Res. 2024 Jan;176:111567. doi: 10.1016/j.jpsychores.2023.111567. Epub 2023 Dec 12.
Treatment expectations reportedly shape treatment outcomes, but have not been studied in the context of multimodal therapy in Crohn's disease (CD). Therefore, the current study investigated the role of treatment expectations for subjective symptom changes in CD patients who have undergone an integrative multimodal therapy program.
Validated questionnaires were completed at the start of the treatment program and post intervention. Pre-treatment expectations and experienced symptom change were assessed with the Generic Rating Scale for Previous Treatment Experiences, Treatment Expectations, and Treatment Effects (GEEE); stress levels were quantified with the Perceived Stress Scale (PSS-10) and disease specific quality of life was quantified with the disease-specific Inflammatory Bowel Disease Questionnaire (IBDQ). We performed multiple linear and Bayesian regression to determine how expectations related to symptom change.
N = 71 CD patients (66.2% female) were included. Stronger expectations regarding symptom improvement (b = 0.422, t = 3.70, p < .001) were associated with higher experienced symptom improvement. Additionally, Bayesian analysis provided strong evidence for including improvement expectations as a predictor of improvement experience (BF = 13.78).
In line with research in other disorders, we found that positive treatment expectations were associated with experienced symptom improvement. In contrast, we found no indication that an experience of symptom worsening was associated with positive or negative baseline treatment expectations. Induction of positive expectations might be a potential avenue for improving treatment outcomes in CD therapy.
据报道，治疗期望会影响治疗结果，但尚未在克罗恩病（CD）的多模式治疗背景下进行研究。因此，本研究调查了在接受综合多模式治疗计划的 CD 患者中，治疗期望对主观症状变化的作用。
在治疗计划开始时和干预后完成了经过验证的问卷。使用通用既往治疗经验、治疗期望和治疗效果量表（GEEE）评估治疗前的期望和经历的症状变化；使用感知压力量表（PSS-10）量化压力水平，使用特定于疾病的炎症性肠病问卷（IBDQ）量化疾病特异性生活质量。我们进行了多次线性和贝叶斯回归，以确定期望与症状变化的关系。
共纳入 71 名 CD 患者（66.2%为女性）。对症状改善的期望越强（b=0.422，t=3.70，p<.001），经历的症状改善越大。此外，贝叶斯分析提供了强有力的证据，表明将改善期望作为改善体验的预测因素（BF=13.78）。
与其他疾病的研究一致，我们发现积极的治疗期望与经历的症状改善有关。相反，我们没有发现症状恶化的体验与积极或消极的基线治疗期望有关的迹象。诱导积极的期望可能是改善 CD 治疗中治疗结果的潜在途径。
