J Psychosom Res. 2023 Jun;169:111232. doi: 10.1016/j.jpsychores.2023.111232.Epub 2023 Mar 14.

Colette Naude ¹, David Skvarc ², Simon Knowles ³, Lahiru Russell ⁴, Subhadra Evans ², Antonina Mikocka-Walus ²

Author information

¹School of Psychology, Deakin University Geelong, Melbourne, VIC, Australia. Electronic address: naudec@deakin.edu.au.

²School of Psychology, Deakin University Geelong, Melbourne, VIC, Australia.

³Department of Psychology, Swinburne University of Technology, VIC, Australia.

⁴Faculty of Health, Institute for Health Transformation, Deakin University Geelong, Melbourne, Australia.

Abstract

Background: Mental health has been identified as contributing to the pathogenesis of Inflammatory Bowel Disease (IBD). Resultingly, psychotherapeutic interventions, such as Mindfulness-Based Interventions (MBI), have been increasingly investigated for improving IBD outcomes.

Objectives: To systematically review the current state of evidence of MBI's for individuals living with IBD.

Methods: We performed a systematic review searching Medline, PsychINFO, CINAHL, Embase, Cochrane and Scopus, to identify controlled clinical trials, investigating MBI's for various IBD biopsychosocial outcomes. Data was pooled using the inverse-variance random effects model, with restricted maximum likelihood estimation, providing the standardized mean difference (SMD) between control and experimental groups, at both short and long-term follow up.

Results: We identified 8 studies with 575 participants. Meta-analytic results found that MBI's were more efficacious than control groups in the short-term improvement of stress (SMD = -0.38, 95% CI [-0.65, -0.10], p = 0.007), mindfulness (SMD = 0.59, 95% CI [0.36, 0.83], p = 0.00001), C-Reactive Protein (CRP) (SMD = -0.25, 95% CI [-0.49, -0.01], p = 0.04) and health-related quality of life (HRQoL) (SMD = 0.45, 95% CI [0.24, 0.66], p = 0.0001) (including all emotional, bowel, social and systemic subscales). This was maintained in the long-term for stress (SMD = -0.44, 95% CI [-0.88, -0.01], p < 0.05) and mindfulness (SMD = 0.52, 95% CI [0.14, 0.90], p = 0.008), but not for HRQoL, with no long-term data available for CRP.

Conclusions: Given that MBI's appear to be effective in improving several IBD outcomes, they may be a useful adjuvant therapy in wholistic IBD care, with further trials warranted.