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Erschienen in: Digestive Diseases and Sciences 9/2018

10.05.2018 | Review

A Systematic Review of the Effectiveness of Psychological Treatments for IBS in Gastroenterology Settings: Promising but in Need of Further Study

verfasst von: Elyse R. Thakur, Jordan Shapiro, Johanna Chan, Mark A. Lumley, Jeffrey A. Cully, Andrea Bradford, Hashem B. El-Serag

Erschienen in: Digestive Diseases and Sciences | Ausgabe 9/2018

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Abstract

Background

Psychological treatments are efficacious for irritable bowel syndrome (IBS) in clinical trials; however, their effectiveness when conducted in gastroenterology practice settings is unclear.

Aim

To perform a systematic review of the types and effects of psychological treatments for IBS conducted in gastroenterology clinics.

Methods

We searched PubMed, EMBASE, and Cochrane central register. Studies conducted in gastroenterology clinic settings with IBS patients who were clinically referred from gastroenterology were included.

Results

We identified 3078 citations, of which only eight studies were eligible. Seven studies compared psychological treatments (average n = 25.7; range 12–43) to controls (average n = 25.4 patients; range 12–47), whereas one study compared two active “bonafide” interventions. Psychological treatments varied (cognitive–behavioral therapy, guided affective imagery, mindfulness, hypnosis, biofeedback, emotional awareness training). However, across approaches, short-term benefits were seen. IBS symptoms improved significantly among patients in cognitive and behavioral therapies, mindfulness-based stress reduction, guided affective imagery, and emotional awareness training compared with controls; there was a similar trend for gut-directed hypnotherapy. Similarly, IBS symptoms improved in a study of two active biofeedback and hypnosis treatments.

Conclusions

Evidence for the effectiveness of psychological treatment in gastroenterology practice is promising but limited. Study designs that involve a blending of efficacy and effectiveness components are needed.
Literatur
2.
Zurück zum Zitat Drossman DA, Whitehead WE, Camilleri M. Irritable bowel syndrome: a technical review for practice guideline development. Gastroenterology. 1997;112:2120–2137.PubMedCrossRef Drossman DA, Whitehead WE, Camilleri M. Irritable bowel syndrome: a technical review for practice guideline development. Gastroenterology. 1997;112:2120–2137.PubMedCrossRef
3.
Zurück zum Zitat Everhart JE, Ruhl CE. Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology. 2009;136:1134–1144.PubMedCrossRef Everhart JE, Ruhl CE. Burden of digestive diseases in the United States Part III: liver, biliary tract, and pancreas. Gastroenterology. 2009;136:1134–1144.PubMedCrossRef
4.
Zurück zum Zitat Inadomi JM, Fennerty MB, Bjorkman D. The economic impact of irritable bowel syndrome. Aliment Pharmacol Ther. 2003;18:671–682.PubMedCrossRef Inadomi JM, Fennerty MB, Bjorkman D. The economic impact of irritable bowel syndrome. Aliment Pharmacol Ther. 2003;18:671–682.PubMedCrossRef
5.
Zurück zum Zitat Dean BB, Aguilar D, Barghout V, et al. Impairment in work productivity and health-related quality of life in patients with IBS. Am J Manag Care. 2005;11:S17–S26.PubMed Dean BB, Aguilar D, Barghout V, et al. Impairment in work productivity and health-related quality of life in patients with IBS. Am J Manag Care. 2005;11:S17–S26.PubMed
6.
Zurück zum Zitat Frank L, Kleinman L, Rentz A, Ciesla G, Kim JJ, Zacker C. Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases. Clin Ther. 2002;24:675–689.PubMedCrossRef Frank L, Kleinman L, Rentz A, Ciesla G, Kim JJ, Zacker C. Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases. Clin Ther. 2002;24:675–689.PubMedCrossRef
7.
Zurück zum Zitat Brandt LJCW, Foxx-Orenstein AE, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol. 2009;104:S1–S35.PubMedCrossRef Brandt LJCW, Foxx-Orenstein AE, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol. 2009;104:S1–S35.PubMedCrossRef
8.
Zurück zum Zitat Chang L. The role of stress on physiological responses and clinical symptoms in irritable bowel syndrome. Gastroenterology. 2011;140:761.PubMedCrossRef Chang L. The role of stress on physiological responses and clinical symptoms in irritable bowel syndrome. Gastroenterology. 2011;140:761.PubMedCrossRef
9.
Zurück zum Zitat Mayer EA, Naliboff BD, Chang L, Coutinho SV. Stress and irritable bowel syndrome. Am J Phyol Gastrointest Liver Physiol. 2001;280:G519–G524.CrossRef Mayer EA, Naliboff BD, Chang L, Coutinho SV. Stress and irritable bowel syndrome. Am J Phyol Gastrointest Liver Physiol. 2001;280:G519–G524.CrossRef
10.
Zurück zum Zitat Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S. Psychological treatments for irritable bowel syndrome: a systematic review and meta-analysis. J Consult Clin Psychol. 2004;72:1100.PubMedCrossRef Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S. Psychological treatments for irritable bowel syndrome: a systematic review and meta-analysis. J Consult Clin Psychol. 2004;72:1100.PubMedCrossRef
11.
Zurück zum Zitat Heymann-Mönnikes I, Arnold R, Florin I, Herda C, Melfsen S, Mönnikes H. The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. Am J Gastroenterol. 2000;95:981–994.PubMedCrossRef Heymann-Mönnikes I, Arnold R, Florin I, Herda C, Melfsen S, Mönnikes H. The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. Am J Gastroenterol. 2000;95:981–994.PubMedCrossRef
12.
Zurück zum Zitat Li L, Xiong L, Zhang S, Yu Q, Chen M. Cognitive-behavioral therapy for irritable bowel syndrome: a meta-analysis. J Psychosom Res. 2014;77:1–12.PubMedCrossRef Li L, Xiong L, Zhang S, Yu Q, Chen M. Cognitive-behavioral therapy for irritable bowel syndrome: a meta-analysis. J Psychosom Res. 2014;77:1–12.PubMedCrossRef
13.
Zurück zum Zitat Ljótsson B, Andersson G, Andersson E, et al. Acceptability, effectiveness, and cost-effectiveness of internet-based exposure treatment for irritable bowel syndrome in a clinical sample: a randomized controlled trial. BMC Gastroenterol. 2011;11:110.PubMedPubMedCentralCrossRef Ljótsson B, Andersson G, Andersson E, et al. Acceptability, effectiveness, and cost-effectiveness of internet-based exposure treatment for irritable bowel syndrome in a clinical sample: a randomized controlled trial. BMC Gastroenterol. 2011;11:110.PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Mahvi-Shirazi M, Fathi-Ashtiani A, Rasoolzade-Tabatabaei S, et al. Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment. Arch Med Sci: AMS. 2012;8:123–129.PubMedPubMedCentralCrossRef Mahvi-Shirazi M, Fathi-Ashtiani A, Rasoolzade-Tabatabaei S, et al. Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment. Arch Med Sci: AMS. 2012;8:123–129.PubMedPubMedCentralCrossRef
15.
Zurück zum Zitat Haghayegh SA, Kalantari M, Molavi H, Talebi M. The efficacy of cognitive-behavior group therapy on health-related quality of life, health anxiety and depression in patients with diarrhea-predominant irritable bowel syndrome. Pak J Med Sci. 2011;27:749–753. Haghayegh SA, Kalantari M, Molavi H, Talebi M. The efficacy of cognitive-behavior group therapy on health-related quality of life, health anxiety and depression in patients with diarrhea-predominant irritable bowel syndrome. Pak J Med Sci. 2011;27:749–753.
16.
Zurück zum Zitat Tkachuk GA, Graff LA, Martin GL, et al. Randomized controlled trial of cognitive-behavioral group therapy for irritable bowel syndrome in a medical setting. J Clin Psychol Med Settings. 2003;10:57–69.CrossRef Tkachuk GA, Graff LA, Martin GL, et al. Randomized controlled trial of cognitive-behavioral group therapy for irritable bowel syndrome in a medical setting. J Clin Psychol Med Settings. 2003;10:57–69.CrossRef
17.
Zurück zum Zitat Park S-H, Han KS, Kang C-B. Relaxation therapy for irritable bowel syndrome: a systematic review. Asian Nurs Res. 2014;8:182–192.CrossRef Park S-H, Han KS, Kang C-B. Relaxation therapy for irritable bowel syndrome: a systematic review. Asian Nurs Res. 2014;8:182–192.CrossRef
18.
Zurück zum Zitat Shinozaki M, Kanazawa M, Kano M, et al. Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback. 2010;35:189–198.PubMedCrossRef Shinozaki M, Kanazawa M, Kano M, et al. Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback. 2010;35:189–198.PubMedCrossRef
19.
Zurück zum Zitat Taneja I, Deepak KK, Poojary G, et al. Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: a randomized control study. Appl Psychophysiol Biofeedback. 2004;29:19–33.PubMedCrossRef Taneja I, Deepak KK, Poojary G, et al. Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: a randomized control study. Appl Psychophysiol Biofeedback. 2004;29:19–33.PubMedCrossRef
20.
Zurück zum Zitat Fernandez C, Perez M, Amigo I, et al. Stress and contingency management in the treatment of irritable bowel syndrome. Stress Med. 1998;14:31–42.CrossRef Fernandez C, Perez M, Amigo I, et al. Stress and contingency management in the treatment of irritable bowel syndrome. Stress Med. 1998;14:31–42.CrossRef
21.
Zurück zum Zitat Shaw G, Srivastava ED, Sadlier M, et al. Stress management for irritable bowel syndrome: a controlled trial. Digestion. 1991;50:36–42.PubMedCrossRef Shaw G, Srivastava ED, Sadlier M, et al. Stress management for irritable bowel syndrome: a controlled trial. Digestion. 1991;50:36–42.PubMedCrossRef
22.
Zurück zum Zitat Webb AN, Kukuruzovic R, Catto‐Smith AG, Sawyer SM. Hypnotherapy for treatment of irritable bowel syndrome. The Cochrane Library 2007. Webb AN, Kukuruzovic R, Catto‐Smith AG, Sawyer SM. Hypnotherapy for treatment of irritable bowel syndrome. The Cochrane Library 2007.
23.
Zurück zum Zitat Lee HH, Choi YY, Choi M-G. The efficacy of hypnotherapy in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Neurogastroenterol Motil. 2014;20:152.PubMedPubMedCentralCrossRef Lee HH, Choi YY, Choi M-G. The efficacy of hypnotherapy in the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Neurogastroenterol Motil. 2014;20:152.PubMedPubMedCentralCrossRef
24.
Zurück zum Zitat Lindfors P, Unge P, Arvidsson P, et al. Effects of gut-directed hypnotherapy on IBS in different clinical settings—results from two randomized, controlled trials. Am J Gastroenterol. 2012;107:276–285.PubMedCrossRef Lindfors P, Unge P, Arvidsson P, et al. Effects of gut-directed hypnotherapy on IBS in different clinical settings—results from two randomized, controlled trials. Am J Gastroenterol. 2012;107:276–285.PubMedCrossRef
25.
Zurück zum Zitat Ford AC, Farhang S, Quigley EM, et al. Effect of antidepressants and psychological therapies, including hypnotherapy, in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2014;109:1350–1365.PubMedCrossRef Ford AC, Farhang S, Quigley EM, et al. Effect of antidepressants and psychological therapies, including hypnotherapy, in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2014;109:1350–1365.PubMedCrossRef
26.
Zurück zum Zitat Zijdenbos IL, de Wit NJ, van der Heijden GJ, Quartero AO. Psychological treatments for the management of irritable bowel syndrome. The Cochrane Library 2009. Zijdenbos IL, de Wit NJ, van der Heijden GJ, Quartero AO. Psychological treatments for the management of irritable bowel syndrome. The Cochrane Library 2009.
27.
Zurück zum Zitat Creed F, Guthrie E, Ratcliff J, et al. The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome. Gastroenterology. 2003;124:303–317.PubMedCrossRef Creed F, Guthrie E, Ratcliff J, et al. The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome. Gastroenterology. 2003;124:303–317.PubMedCrossRef
28.
Zurück zum Zitat Guthrie E, Creed F, Dawson D, et al. A controlled trial of psychological treatment for the irritable bowel syndrome. Gastroenterology. 1991;100:450–457.PubMedCrossRef Guthrie E, Creed F, Dawson D, et al. A controlled trial of psychological treatment for the irritable bowel syndrome. Gastroenterology. 1991;100:450–457.PubMedCrossRef
29.
Zurück zum Zitat Svedlund J, Sjodin I, Ottoson JO, et al. Controlled study of psychotherapy in irritable bowel syndrome. Lancet. 1983;322:589–592.CrossRef Svedlund J, Sjodin I, Ottoson JO, et al. Controlled study of psychotherapy in irritable bowel syndrome. Lancet. 1983;322:589–592.CrossRef
30.
Zurück zum Zitat Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50:217.PubMedPubMedCentralCrossRef Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012;50:217.PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Glasgow RE, Lichtenstein E, Marcus AC. Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003;93:1261–1267.PubMedPubMedCentralCrossRef Glasgow RE, Lichtenstein E, Marcus AC. Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003;93:1261–1267.PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Longstreth G, Hawkey C, Mayer E, et al. Characteristics of patients with irritable bowel syndrome recruited from three sources: implications for clinical trials. Aliment Pharmacol Ther. 2001;15:959–964.PubMedCrossRef Longstreth G, Hawkey C, Mayer E, et al. Characteristics of patients with irritable bowel syndrome recruited from three sources: implications for clinical trials. Aliment Pharmacol Ther. 2001;15:959–964.PubMedCrossRef
33.
Zurück zum Zitat Singal AG, Higgins PD, Waljee AK. A primer on effectiveness and efficacy trials. Clin Transla Gastroenterol. 2014;5:e45.CrossRef Singal AG, Higgins PD, Waljee AK. A primer on effectiveness and efficacy trials. Clin Transla Gastroenterol. 2014;5:e45.CrossRef
34.
Zurück zum Zitat Ford AC, Talley NJ, Schoenfeld PS, Quigley EM, Moayyedi P. Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis. Gut. 2009;58:367–378.PubMedCrossRef Ford AC, Talley NJ, Schoenfeld PS, Quigley EM, Moayyedi P. Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis. Gut. 2009;58:367–378.PubMedCrossRef
35.
Zurück zum Zitat Zernicke KA, Campbell TS, Blustein PK, et al. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med. 2013;20:385–396.PubMedCrossRef Zernicke KA, Campbell TS, Blustein PK, et al. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med. 2013;20:385–396.PubMedCrossRef
36.
Zurück zum Zitat Boltin D, Sahar N, Gil E, et al. Gut-directed guided affective imagery as an adjunct to dietary modification in irritable bowel syndrome. J Health Psychol. 2015;20:712–720.PubMedCrossRef Boltin D, Sahar N, Gil E, et al. Gut-directed guided affective imagery as an adjunct to dietary modification in irritable bowel syndrome. J Health Psychol. 2015;20:712–720.PubMedCrossRef
37.
Zurück zum Zitat Farnam A, Somi MH, Farhang S, Mahdavi N, Besharat MA. The therapeutic effect of adding emotional awareness training to standard medical treatment for irritable bowel syndrome: a randomized clinical trial. J Psychiatr Pract. 2014;20:3–11.PubMedCrossRef Farnam A, Somi MH, Farhang S, Mahdavi N, Besharat MA. The therapeutic effect of adding emotional awareness training to standard medical treatment for irritable bowel syndrome: a randomized clinical trial. J Psychiatr Pract. 2014;20:3–11.PubMedCrossRef
38.
Zurück zum Zitat Dobbin A, Dobbin J, Ross SC, et al. Randomised controlled trial of brief intervention with biofeedback and hypnotherapy in patients with refractory irritable bowel syndrome. J R Coll Physicians Edinb. 2013;43:15–23.PubMedCrossRef Dobbin A, Dobbin J, Ross SC, et al. Randomised controlled trial of brief intervention with biofeedback and hypnotherapy in patients with refractory irritable bowel syndrome. J R Coll Physicians Edinb. 2013;43:15–23.PubMedCrossRef
39.
Zurück zum Zitat Wiklund I, Fullerton S, Hawkey C, et al. An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol. 2009;38:947–954. Wiklund I, Fullerton S, Hawkey C, et al. An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol. 2009;38:947–954.
40.
Zurück zum Zitat Francis C, Morris J, Whorwell P. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11:395–402.PubMedCrossRef Francis C, Morris J, Whorwell P. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11:395–402.PubMedCrossRef
41.
Zurück zum Zitat Beck AT, Steer R, Brown G. Beck Depression Inventory Manual. San Antonio, TX: The Psychological Corporation, Harcourt Brace Jovanovich; 1996. Beck AT, Steer R, Brown G. Beck Depression Inventory Manual. San Antonio, TX: The Psychological Corporation, Harcourt Brace Jovanovich; 1996.
42.
Zurück zum Zitat Vassend O, Skrondal A. The problem of structural indeterminacy in multidimensional symptom report instruments. The case of SCL-90-R. Behav Res Ther. 1999;37:685–701.PubMedCrossRef Vassend O, Skrondal A. The problem of structural indeterminacy in multidimensional symptom report instruments. The case of SCL-90-R. Behav Res Ther. 1999;37:685–701.PubMedCrossRef
43.
Zurück zum Zitat Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–370.PubMedCrossRef Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361–370.PubMedCrossRef
44.
Zurück zum Zitat Spielberger CDGR, Lushene RE. STAI Manual for the State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970. Spielberger CDGR, Lushene RE. STAI Manual for the State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.
45.
Zurück zum Zitat Patrick DL, Drossman DA, Frederick IO, Dicesare J, Puder KL. Quality of life in persons with irritable bowel syndrome (development and validation of a new measure). Dig Dis Sci. 1998;43:400–411.PubMedCrossRef Patrick DL, Drossman DA, Frederick IO, Dicesare J, Puder KL. Quality of life in persons with irritable bowel syndrome (development and validation of a new measure). Dig Dis Sci. 1998;43:400–411.PubMedCrossRef
46.
Zurück zum Zitat Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30:473–483.PubMedCrossRef
47.
Zurück zum Zitat Eypasch E, Wood-Dauphinee S, Williams J, Ure B, Neugeauer E, Troidl HP. The Gastrointestinal Quality of Life Index. A clinical index for measuring patient status in gastroenterologic surgery. Chirurg. 1993;64:264–274.PubMed Eypasch E, Wood-Dauphinee S, Williams J, Ure B, Neugeauer E, Troidl HP. The Gastrointestinal Quality of Life Index. A clinical index for measuring patient status in gastroenterologic surgery. Chirurg. 1993;64:264–274.PubMed
48.
Zurück zum Zitat Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology. 2002;122:1140–1156.PubMedCrossRef Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology. 2002;122:1140–1156.PubMedCrossRef
49.
Zurück zum Zitat Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S. Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. J Contin Educ Health Prof. 2007;27:94–102.PubMedCrossRef Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S. Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. J Contin Educ Health Prof. 2007;27:94–102.PubMedCrossRef
50.
Zurück zum Zitat Cabana MD, Rand CS, Powe NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–1465.PubMedCrossRef Cabana MD, Rand CS, Powe NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–1465.PubMedCrossRef
51.
Zurück zum Zitat Mikocka-Walus A, Turnbull D, Andrews JM, Moulding N, Wilson I, Holtmann G. Psychogastroenterology: a call for psychological input in Australian gastroenterology clinics. Intern Med J. 2009;39:127–130.PubMedCrossRef Mikocka-Walus A, Turnbull D, Andrews JM, Moulding N, Wilson I, Holtmann G. Psychogastroenterology: a call for psychological input in Australian gastroenterology clinics. Intern Med J. 2009;39:127–130.PubMedCrossRef
Metadaten
Titel
A Systematic Review of the Effectiveness of Psychological Treatments for IBS in Gastroenterology Settings: Promising but in Need of Further Study
verfasst von
Elyse R. Thakur
Jordan Shapiro
Johanna Chan
Mark A. Lumley
Jeffrey A. Cully
Andrea Bradford
Hashem B. El-Serag
Publikationsdatum
10.05.2018
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 9/2018
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5095-3

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