Cognitive Behavioural Therapy tailored specifically for IBS works over the phone or online

IBS is a common condition causing abdominal pain, bloating and altered bowel habit

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder affecting 10 – 20 per cent of people. Abdominal pain, bloating and altered bowel habit significantly affect patient’s quality of life and can force them to take days off work.

Previous research (the ACTIB trial) led by Professor Hazel Everitt at the University of Southampton in collaboration with researchers at King’s College London, showed that that Cognitive Behavioural Therapy (CBT) tailored specifically for IBS and delivered over the telephone or through an interactive website is more effective in relieving the symptoms of IBS than current standard care one year after treatment.

This 24 month follow up research published in Lancet Gastroenterology and Hepatology this week has shown that benefits continue two years after treatment despite patients having no further therapy after the initial CBT course. These results are important as previously there was uncertainty whether the initial benefits could be sustained in the long term. Currently there is limited availability of CBT for IBS in a resource constrained NHS but this research indicates that easily accessible treatment could be provided to a large number of patients and provide them with effective, long-term relief.

Professor Everitt added: “the fact that both telephone and web based CBT sessions were shown to be effective treatments is a really important and exciting discovery. Patients are able to undertake these treatments at a time convenient to them, without having to travel to clinics and we now know that the benefits can last long term.’’

The study was funded by the Health Technology and Assessment Programme of the National Institute for Health Research (NIHR).

The research team are working towards making the CBT therapy widely available in the NHS.

Learn more: Benefits of cognitive behavioural therapy for IBS continue 2 years after treatment


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Children and adolescents with OCD benefit from cognitive behavioural therapy

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The vast majority of children and adolescents who receive cognitive behavioural therapy treatment for OCD thrive and live without symptoms a year after the end of treatment. This is shown by new research from Aarhus University’s Centre for Child and Adolescent Psychiatry in Risskov.

Some children and adolescents think that they will have an accident if they do not count all the lampposts on their way to school. Or cannot leave the house unless they have washed their hands precisely twenty-five times. They suffer from OCD, Obsessive Compulsive Disorder, which is an extremely stressful psychiatric disorder that affects between 0.25 and 4 per cent of all children. Fortunately, the treatment method – cognitive behavioural therapy – is both effective and well-documented. The hitherto largest research study of OCD treatment for children and adolescents aged 7-17 now shows that cognitive behavioural therapy also has a long-lasting effect. The Nordic research project, which involves researchers from Aarhus University and child and adolescent psychiatry clinics in Norway and Sweden, has shown that children and adolescents who benefited from the therapy were also free of patterns of compulsive behaviour and compulsive thoughts one year after the treatment ended.

“The study makes clear that cognitive behavioural therapy reaches beyond the treatment period. This knowledge is important, both for the practitioners, but not least for the affected children and their families,” says Per Hove Thomsen, one of the researchers behind the study and professor at Aarhus University and consultant at the Centre for Child and Adolescent Psychiatry, Risskov. He is also the final author of the results, which have just been published in the scientific journal Journal of the American Academy of Child and Adolescent Psychiatry.

Normal development difficult with OCD

“OCD is a very difficult disorder which demands a colossal amount of the child in question. It is almost impossible to live a normal life as a child and teenager with a normal level of development, if you need to wash your hands a hundred times a day in a particular way in order not to be killed, which is something that compulsive thinking can dictate. For the same reason, early intervention is necessary before the disorder has disabling consequences in adulthood,” says Per Hove Thomsen.

The children from the study were treated with cognitive behavioural therapy, which is a behavioural psychological treatment. Fundamentally it involves getting help to refrain from acting on compulsive thoughts and instead incorporating new thought patterns. The method also involves the whole family, as the effect is strengthened by the mother and father supporting the methods that the child is given to overcome the OCD.

Furthermore, according to Psychologist and PhD David R.M.A Højgaard, who is the lead author of the scientific article, once the treatment is completed a watchful eye should still be kept on the child or teenager.

“The results of the study indicate that to maintain the effect in the longer term you need to remain aware and detect OCD symptoms so you can nip them in the bud before they develop and become worse. This is done by offering booster sessions to refresh the treatment principles and thereby prevent OCD from getting a foothold again,” says David R.M.A Højgaard.

Not enough therapists

The collaboration with the Norwegian and Swedish child and adolescent psychiatry clinics has added knowledge that can be significant for the organisation of OCD treatment.

“The biggest challenge facing OCD treatment is that there are not enough specially trained therapists and treatment facilities to meet needs. The study shows that if the level of training of therapists is consolidated and if supervision is provided, then it is possible to provide treatment in an isolated corner of Norway that is just as effective as the treatment provided at a university clinic,” says Per Hove Thomsen.

The study is part of The Nordic Long Term OCD Treatment Study (NordLOTS) and comprises 269 children and adolescents with OCD from Denmark, Norway and Sweden.

The results showed that 92 per cent of the 177 children and teenagers who immediately benefited from the treatment were still healthy and free of symptoms one year after the treatment ended. Of these, 78 per cent had no clinical symptoms of OCD.



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Can magnetic fields alleviate anxiety?

People suffering from a fear of heights experience the anxiety also in virtual reality – even though they are aware that they are not really in a dangerous situation. (Photo: VTPlus)

It is possible to unlearn fears. And this works even better when a specific region of the brain has previously been stimulated magnetically. This has been shown by researchers from the Würzburg University Hospital in a new study.

Nearly one in seven Germans suffer from an anxiety disorder. Some panic upon boarding an aircraft, others find it impossible to enter a room with a spider on the wall and again others prefer the staircase over the elevator – even to get to the tenth floor – because riding in elevators elevates their heart rate.

What sounds like funny anecdotes is often debilitating for the sufferers. Sometimes their anxiety can affect them to a point that they are unable to follow a normal daily routine. But help is available: “Cognitive behavioural therapy is an excellent treatment option,” says Professor Martin J. Herrmann, a psychologist at the Center of Mental Health of the Würzburg University Hospital. This form of therapy deliberately exposes anxiety patients to the situations they feel threatened by – under the individual psychological supervision of an expert.

Brain stimulation improves response

However, current studies have shown that this type of intervention does not benefit all persons in equal measure. This is why Herrmann and researchers from the Department of Clinical Psychology of the University of Würzburg have been looking for ways to improve the patients’ response to cognitive behavioural therapy – by using the so-called transcranial magnetic stimulation. In fact, a positive effect was found on the study participants treated with this method.

“We knew from previous studies that a specific region in the frontal lobe of the human brain is important for unlearning anxiety,” Martin J. Herrmann explains the work of the Würzburg scientists. He goes on to say that initial studies have shown that magnetically stimulating this brain region can improve the effectiveness of unlearning anxiety responses in the laboratory. In its recently published study, the team investigated whether this also works for treating a fear of heights.

The study

To this end, 39 participants with a pronounced fear of heights were taken to dizzying heights during two sessions – however not in real life but using virtual reality. It does not matter that the environment is not real: “The people feel actual fear also in a virtual reality – although they know that they are not really in a dangerous situation,” Herrmann explains.

The scientists stimulated the frontal lobe of some of the anxiety patients for about 20 minutes before entering the virtual world; the other group was only administered a pseudo stimulation. The result: “The findings demonstrate that all participants benefit considerably from the therapy in virtual reality and the positive effects of the intervention are still clearly visible even after three months,” Herrmann explains. And what is more: By stimulating the frontal lobe, the therapy response is accelerated.

Next the researchers want to study whether this method is also suitable to treat other forms of anxiety by conducting a further virtual reality therapy study for arachnophobic patients.

Learn more: Magnetic fields to alleviate anxiety


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