The Effect of Integrating Cognitive-Behavioral Therapy and Mindfulness Therapy on Lifestyle of Women with Irritable Bowel Syndrome

Mohammadi, Habibeh; Khalatbari, Javad; Abolmaali, Khadijeh

doi:10.30476/whb.2021.91397.1124

Document Type : Research Article

Authors

¹ Department of Psychology, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran

² Department of Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran

https://doi.org/10.30476/whb.2021.91397.1124

Abstract

Background: Psychological distresses and stresses are believed to significantly increase the symptoms of irritable bowel syndrome (IBS). In contrast, healthy lifestyle plays an effective role in the prevention and treatment of IBS. The present article investigated the effect of integrating cognitive-behavioral therapy and mindfulness therapy on the lifestyle of patients with IBS in Tehran.
Methods: This study was quasi-experimental (pre-test, post-test, and a one-month follow-up design, and a control group). The statistical population herein included all the women with IBS referred to the Gastroenterology Research Center of Shariati Hospital in Tehran in 2020. We selected 30 patients who were willing to participate in the study using convenience sampling and randomly divided them into the control and experimental groups (n=15 per group). The experimental group underwent 12 sessions (90-minute sessions, two days a week) of integrating cognitive-behavioral therapy and mindfulness therapy, yet the control group received no intervention. The research instrument included the Lifestyle Questionnaire (LSQ). Data analysis was carried out using repeated measures ANOVA.
Results: The results indicated that integrating cognitive-behavioral therapy and mindfulness therapy effectively improved lifestyles in women with IBS (p <0.001). The mean post-test and follow-up scores of the experimental group were 162.58±30.83 and 166.00±26.61, respectively, which increased compared to the pre-test (110.58±10.02), post-test (107.17±9.52), and follow-up (103.33±7.24) of the control group.
Conclusion: Integrating cognitive-behavioral therapy and mindfulness therapy could be recommended as an effective training to improve the lifestyle of women with IBS.

Keywords

References

1. Enck P, Aziz Q, Barbara G, Farmer AD, Fukudo S, Mayer EA, et al. Irritable bowel syndrome. Nat Rev Dis Primers. 2016;2:16014. doi: 10.1038/nrdp.2016.14. PubMed PMID: 27159638; PubMed Central PMCID: PMC5001845. ## 2. Creed F, Ratcliffe J, Fernandes L, Palmer S, Rigby C, Tomenson B, et al. Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders. Br J Psychiatry. 2005;186:507-15. doi: 10.1192/bjp.186.6.507. PubMed PMID: 15928362. ## 3. Lackner JM, Gudleski GD, Ma CX, Dewanwala A, Naliboff B, Representing the IBSOS Outcome Study Research Group. Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS. Am J Gastroenterol. 2014;109(11):1815-23. doi: 10.1038/ajg.2014.241. PubMed PMID: 25223577; PubMed Central PMCID: PMC5110208. ## 4. Mayer EA, Savidge T, Shulman RJ. Brain-gut microbiome interactions and functional bowel disorders. Gastroenterology. 2014;146(6):1500-12. doi: 10.1053/j.gastro.2014.02.037. PubMed PMID: 24583088; PubMed Central PMCID: PMC4114504. ## 5. Soares RLS. Irritable bowel syndrome: a clinical review. World J Gastroenterol. 2014;20(34):12144-60. doi: 10.3748/wjg.v20.i34.12144. PubMed PMID: 25232249; PubMed Central PMCID: PMC4161800. ## 6. Pigrau M, Rodiño-Janeiro BK, Casado-Bedmar M, Lobo B, Vicario M, Santos J, et al. The joint power of sex and stress to modulate brain-gut-microbiota axis and intestinal barrier homeostasis: implications for irritable bowel syndrome. Neurogastroenterol Motil. 2016;28(4):463-86. doi: 10.1111/nmo.12717. PubMed PMID: 26556786. ## 7. Ghoshal UC, Ghoshal U. Small Intestinal Bacterial Overgrowth and Other Intestinal Disorders. Gastroenterol Clin North Am. 2017;46(1):103-120. doi: 10.1016/j.gtc.2016.09.008. PubMed PMID: 28164845. ## 8. Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis. Gut. 2007;56(8):1066-71. doi: 10.1136/gut.2006.108811. PubMed PMID: 17324974; PubMed Central PMCID: PMC1955525. ## 9. Park B-H, Lee K-S. Model Predicting Irritable Bowel Syndrome Severity in University Students. Journal of Korean Biological Nursing Science. 2017;22(2):91–101. doi: 10.7586/jkbns.2020.22.2.90. ## 10. Muscatello MRA, Bruno A, Mento C, Pandolfo G, Zoccali RA. Personality traits and emotional patterns in irritable bowel syndrome. World J Gastroenterol. 2016;22(28):6402-15. doi: 10.3748/wjg.v22.i28.6402. PubMed PMID: 27605876; PubMed Central PMCID: PMC4968122. ## 11. Kopczyńska M, Mokros Ł, Pietras T, Małecka-Panas E. Quality of life and depression in patients with irritable bowel syndrome. Prz Gastroenterol. 2018;13(2):102-108. doi: 10.5114/pg.2018.75819. PubMed PMID: 30002768; PubMed Central PMCID: PMC6040097. ## 12. Jamali R, Jamali A, Poorrahnama M, Omidi A, Jamali B, Moslemi N, et al. Evaluation of health-related quality of life in irritable bowel syndrome patients. Health Qual Life Outcomes. 2012;10:12. doi: 10.1186/1477-7525-10-12. PubMed PMID: 22284446; PubMed Central PMCID: PMC3298501. ## 13. Hajishafiee M, Keshteli AH, Saneei P, Feinle-Bisset C, Esmaillzadeh A, Adibi P. Healthy lifestyle score and irritable bowel syndrome: A cross-sectional study in adults. Neurogastroenterol Motil. 2020;32(5):e13793. doi: 10.1111/nmo.13793. PubMed PMID: 31912611. ## 14. Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014;20(22):6759-73. doi: 10.3748/wjg.v20.i22.6759. PubMed PMID: 24944467; PubMed Central PMCID: PMC4051916. ## 15. Tripathi R, Mehrotra S. Irritable bowel syndrome and its psychological management. Ind Psychiatry J. 2015;24(1):91-3. doi: 10.4103/0972-6748.160947. PubMed PMID: 26257492; PubMed Central PMCID: PMC4525441. ## 16. Ballou S, Keefer L. Psychological Interventions for Irritable Bowel Syndrome and Inflammatory Bowel Diseases. Clin Transl Gastroenterol. 2017;8(1):e214. doi: 10.1038%2Fctg.2016.69. PubMed PMID: 28102860; PubMed Central PMCID: PMC5288603. ## 17. Laird KT, Tanner-Smith EE, Russell AC, Hollon SD, Walker LS. Short-term and Long-term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2016;14(7):937-947. doi: 10.1016/j.cgh.2015.11.020. PubMed PMID: 26721342. ## 18. Hetterich L, Stengel A. Psychotherapeutic Interventions in Irritable Bowel Syndrome. Front Psychiatry. 2020;11:286. doi: 10.3389/fpsyt.2020.00286. PubMed PMID: 32425821; PubMed Central PMCID: PMC7205029. ## 19. Norouzi A, Fakhri M, Talebi R, Roshandel G, Mohammadi R. Effectiveness of Mindfulness – Based Cognitive Therapy on coping style and gastrointestinal symptoms in patients with irritable bowel syndrome. Jorjani Biomed J. 2017;5(2):100-8. Persian. ## 20. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. doi: 10.3758/BF03193146. PubMed PMID: 17695343. ## 21. Lali M, Abedi, A, Kajbaf MB. Construction and Validation of the Lifestyle Questionnaire (LSQ). Psychological Research. 2012;15(1):64-80. Persian. ## 22. Motabi F. Fati L. On Becoming a Cognitive Behavioral Therapist. Tehran: Danjeh; 2013. Persian. ## 23. Hawton K, Salkovskis PM, Kirk J, Clark DM. Cognitive behaviour therapy for psychiatric problems: A practical guide. Oxford University Press; 1989. doi: 10.1093/med:psych/9780192615879.001.0001. ## 24. Bowen S, Chawla N, Marlatt GA. Mindfulness-based relapse prevention for addictive behaviors: A clinician's guide. Guilford Press; 2011. ## 25. Zhao SR, Ni XM, Zhang XA, Tian H. Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients. World J Clin Cases. 2019;7(21):3446-62. doi: 10.12998/wjcc.v7.i21.3446. PubMed PMID: 31750328; PubMed Central PMCID: PMC6854400. ## 26. Alipour A, Rezai A, Hashemi T, Yousefpour N. The effectiveness of cognitive behavioral therapy focused on lifestyle modification to increase monitoring vital signs and coronary heart disease and psychological well-being. Health Psychology. 2017;5(20):125-136. Persian. ## 27. Mönnikes H. Quality of life in patients with irritable bowel syndrome. J Clin Gastroenterol. 2011;45 Suppl:S98-101. doi: 10.1097/mcg.0b013e31821fbf44. PubMed PMID: 21666428. ## 28. Joć EB, Mądro A, Celiński K, Słomka M, Kasztelan-Szczerbińska B, Pacian A, et al. Quality of life of patients with irritable bowel syndrome before and after education. Psychiatr Pol. 2015;49(4):821-33. doi: 10.12740/PP/26078. PubMed PMID: 26488357. ## 29. de MendonÇa APM, Yamashita LM, Silva ED, Solar I, Santos LAO, Vasques ACJ. Nutritional status, quality of life and life habits of women with irritable bowel syndrome: a case-control study. Arq Gastroenterol. 2020;57(2):114-120. doi: 10.1590/s0004-2803.202000000-22. PubMed PMID: 32490902. ## 30. Tanaka Y, Kanazawa M, Fukudo S, Drossman DA. Biopsychosocial model of irritable bowel syndrome. J Neurogastroenterol Motil. 2011;17(2):131-9. doi: 10.5056/jnm.2011.17.2.131. PubMed PMID: 21602989; PubMed Central PMCID: PMC3093004. ## 31. Roohafza H, Keshteli AH, Daghaghzadeh H, Afshar H, Erfani Z, Adibi P. Life stressors, coping strategies, and social supports in patients with irritable bowel syndrome. Adv Biomed Res. 2016;5:158. doi: 10.4103/2277-9175.190935. PubMed PMID: 27761433; PubMed Central PMCID: PMC5070037. ## 32. Cline L, Bailey K, Gammage K. “I Don’t Think It Matters What Age Group You Are in”: Exploring Body Image Coping Strategies in Women Aged 55+. Women Health Bull. 2018;5(3):1-5. doi: 10.5812/whb.61048. ## 33. Ahmadipour H, Kiarash G. Promoting Healthy Lifestyles for Women in Kerman, Iran: A Population-Based Study. Women Health Bull. 2016;3(3):1-4. doi: 10.17795/whb-33612. ## 34. Jahanbin I, Aflaki E, Ghaem H. Relationship between Lifestyle Factors and Bone Density in Women Referring to Bone Densitometry Research Center in Shiraz, Iran. Women Health Bull. 2014;1(1):1-4. doi: 10.17795/whb-18960. ##

Women’s Health Bulletin

The Effect of Integrating Cognitive-Behavioral Therapy and Mindfulness Therapy on Lifestyle of Women with Irritable Bowel Syndrome

References

References

Volume 8, Issue 4 - Serial Number 31
October 2021
Pages 220-227

The Effect of Integrating Cognitive-Behavioral Therapy and Mindfulness Therapy on Lifestyle of Women with Irritable Bowel Syndrome

References

References

Volume 8, Issue 4 - Serial Number 31October 2021Pages 220-227

Volume 8, Issue 4 - Serial Number 31
October 2021
Pages 220-227