Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis

Authors

  • L. Keefer,

    Corresponding author
    1. Center for Psychosocial Research in GI, Northwestern University, Chicago, IL, USA
    2. Division of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
    • Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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  • T. H. Taft,

    1. Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
    2. Center for Psychosocial Research in GI, Northwestern University, Chicago, IL, USA
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  • J. L. Kiebles,

    1. Edward Hines, Jr. VA Hospital, Mental Health/Rehabilitation Services, Hines, IL, USA
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  • Z. Martinovich,

    1. Division of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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  • T. A. Barrett,

    1. Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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  • O. S. Palsson

    1. Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, NC, USA
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Correspondence to:

Dr L. Keefer, Division of Gastroenterology, Center for Psychosocial Research in GI, Northwestern University, 676 North St. Clair, Suite 1400, Chicago, IL 60611, USA.

E-mail: laurie.keefer@northwestern.edu

Summary

Background

Psychotherapy is not routinely recommended for in ulcerative colitis (UC). Gut-directed hypnotherapy (HYP) has been linked to improved function in the gastrointestinal tract and may operate through immune-mediated pathways in chronic diseases.

Aims

To determine the feasibility and acceptability of HYP and estimate the impact of HYP on clinical remission status over a 1-year period in patients with an historical flare rate of 1.3 times per year.

Methods

A total of 54 patients were randomised at a single site to seven sessions of gut-directed HYP (n = 26) or attention control (CON; n = 29) and followed for 1 year. The primary outcome was the proportion of participants in each condition that had remained clinically asymptomatic (clinical remission) through 52 weeks post treatment.

Results

One-way analysis of variance comparing HYP and CON subjects on number of days to clinical relapse favoured the HYP condition [F = 4.8 (1, 48), P = 0.03] by 78 days. Chi-squared analysis comparing the groups on proportion maintaining remission at 1 year was also significant [χ2(1) = 3.9, P = 0.04], with 68% of HYP and 40% of CON patients maintaining remission for 1 year. There were no significant differences between groups over time in quality of life, medication adherence, perceived stress or psychological factors.

Conclusion

This is the first prospective study that has demonstrated a significant effect of a psychological intervention on prolonging clinical remission in patients with quiescent ulcerative colitis (Clinical Trial # NCT00798642).

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