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Reducing psychologic distress in patients with inflammatory bowel disease by cognitive-behavioral treatment: exploratory study of effectiveness. Mussell M, Bocker U, Nagel N, Olbrich R, Singer MV. Scand J Gastroenterol. 2003; 38:755–762.

A group-based patient education program for high-anxiety patients with Crohn disease or ulcerative colitis. Larsson K, Sundberg Hjelm M, Karlbom U, Nordin K, Anderberg UM, Loof L. Scand J Gastroenterol. 2003;38:763–769.

The first of these two studies sought to reveal whether group therapy utilizing a standardized cognitive-behavioral approach is effective in reducing disease-specific concerns and facilitating adaptive coping in outpatients with inflammatory bowel disease in remission. Controlling for both disease activity and medical therapy, the prospective design also set out to examine the potential stability of any positive therapeutic effects over time, as well as whether gender and disease type (Crohn's disease versus ulcerative colitis) had an impact on the outcome. All study participants underwent a standard protocol of 12 weekly sessions in group format. Following cognitive–behavioral principles, the treatment involved disease-related education (provided by a gastroenterologist), psycho-education on the relationship of thoughts and emotions to the genesis of distress, training in cognitive coping strategies and progressive muscle relaxation teaching. Baseline measures of IBD activity, general psychologic distress, specific IBD-related concerns, depressive symptoms, coping styles, and potential psychiatric disorders were obtained using standardized validated instruments. The same measures were taken at the end of the treatment period, as well as at three follow-up assessments separated by 3-month intervals.

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