Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial

Quirine M Bredero; Joke Fleer; Ans Smink; Greetje Kuiken; Joke Potjewijd; Marleen Laroy; Marijn C Visschedijk; Maurice Russel; Mark van der Lugt; Maarten A C Meijssen; Egbert Jan van der Wouden; Gerard Dijkstra; Maya J Schroevers

doi:10.1016/j.jpsychores.2024.111949

Long-term treatment outcomes of mindfulness-based cognitive therapy for fatigue in patients with inflammatory bowel disease: Results of a randomized controlled trial

J Psychosom Res. 2024 Dec:187:111949. doi: 10.1016/j.jpsychores.2024.111949. Epub 2024 Oct 11.

Authors

Affiliations

¹ Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].
² Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].
³ Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].
⁴ Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].
⁵ Isala Clinics, Zwolle, the Netherlands. Electronic address: [email protected].
⁶ Mindfulness Training Twente - Zeilen op de wind, Boekelo, the Netherlands. Electronic address: [email protected].
⁷ Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].
⁸ Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, the Netherlands. Electronic address: [email protected].
⁹ Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, the Netherlands. Electronic address: [email protected].
¹⁰ Department of Gastroenterology, Isala Clinics, Zwolle, the Netherlands. Electronic address: [email protected].
¹¹ Department of Gastroenterology, Isala Clinics, Zwolle, the Netherlands. Electronic address: [email protected].
¹² Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].
¹³ Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: [email protected].

PMID: 39418854
DOI: 10.1016/j.jpsychores.2024.111949

Abstract

Objectives: Fatigue is prevalent in patients with inflammatory bowel disease (IBD) in remission. Previously, we showed that fatigued IBD patients experienced a significant decrease in fatigue after receiving mindfulness-based cognitive therapy (MBCT). The current study examined to what extent these short-term beneficial effects of MBCT on fatigue were maintained over nine months follow-up, and whether patient characteristics were associated with clinically relevant improvement in fatigue.

Methods: A randomized controlled trial, including an MBCT and waiting-list control condition, was performed in fatigued IBD patients in remission. For this study, we analysed long-term outcomes of 108 patients who received MBCT (either directly or after three months waiting). The primary outcome was fatigue, assessed with the Checklist Individual Strenght-20. Secondary outcomes included fatigue interference, depression, anxiety, and quality of life.

Results: The reduced level of fatigue post-treatment did not change significantly during follow-up (F(2,76) = 1.68, p = 0.19). In total, 29% of patients reported clinically relevant improvement from pre-treatment to nine months follow-up. We found few significant differences in baseline characteristics between those reporting clinically relevant improvement and those not, except that patients who improved were significantly more often unemployed (χ²(1, n = 73) = 4.40, p = 0.04). Secondary outcomes, which did not change significantly during MBCT, also remained stable during follow-up.

Conclusion: Findings suggest that reductions in IBD-related fatigue after receiving MBCT are sustained over nine months follow-up, with around one-third of patients reporting clinically relevant improvement from pre-treatment to follow-up. Employment status might be related to improvements in fatigue. Future research is needed to confirm these long-term outcomes.

Preregistration: ClinicalTrials.gov ID: NCT03162575.

Keywords: Fatigue; Inflammatory bowel disease; Long-term effects; Mindfulness-based cognitive therapy; Randomized controlled trial.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Anxiety / therapy
Cognitive Behavioral Therapy* / methods
Depression / complications
Depression / therapy
Fatigue* / etiology
Fatigue* / therapy
Female
Follow-Up Studies
Humans
Inflammatory Bowel Diseases* / complications
Inflammatory Bowel Diseases* / psychology
Inflammatory Bowel Diseases* / therapy
Male
Middle Aged
Mindfulness* / methods
Quality of Life*
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT03162575