Study Of Cognitive Characteristics, And Effects Of Cognitive Behavioral Therapy On Cognitions, Emotions, And Symptom Severity Of IBS-D Patients

ObjectiveTo evaluate the cognitive characteristics of IBS-D patients,and effects of cognitive behavioral therapy on cognitions,emotions,and symptom severity of IBS-D patients.MethodsEvaluate 120 IBS-D patients with questionnaires,and divided them into 4 groups and treat them with cognitive-behavioral therapy,or mirtazapine therapy,or cognitive-behavioral therapy combined mirtazapine or waiting for therapy.8 weeks later,evaluate the effects of different therapies on cognitions,emotions and symptoms by answering the same questionnaires.Questionnaires including:irritable bowel syndrome-quality of life questionnaire(IBS-QOL),irritable bowel syndrome-symptom severity scales(IBS-SSS),automatic thoughts questionnaire(ATQ),dysfunctional attitudes scales(DAS),coping strategy questionnaire(CSQ),Hamilton anxiety scale (HAMA),and Hamilton depression scale(HAMD).Results1.IBS-D patients have more negative automatic thoughts(P=0.000),more dysfunctional attitudes(all factors except for perfectionism,P＜0.05),and more maladaptive pain coping strategies than healthy controls(more catastrophizing and praying strategies:P=0.000 and P=0.013);2.Three therapies are equally efficient in decreasing negative automatic thoughts, fragile and dependency.Either of the three therapies could reduce maladaptive coping strategies of pain,CBT combined with mirtazapine is the most efficient,and CBT is superior to mirtazapine.Besides,CBT and combined therapy could help forming adaptive strategies(P＜0.05),while mirtazapine could not(P＞0.05). 3.CBT,mirtazapine,and CBT combined mirtazapine are all statistically efficient in decreasing anxiety and depression.CBT combined with mirtazapine is superior to the others,and mirtazapine is superior to CBT.4.CBT,mirtazapine,and CBT combined mirtazapine are all statistically efficient in reducing the severity of symptoms,advancing quality of life.CBT combined with mirtazapine is superior to the others,and mirtazapine is superior to CBT.Conclusions1.IBS-D patients have more negative automatic thoughts,dysfunctional attitudes, and maladaptive coping strategies.2.CBT,mirtazapine,CBT combined with mirtazapine are all effective in reducing negative automatic thoughts,and maladaptive coping strategies,but not in reducing dysfunctional attitudes.Besides,CBT and combined therapy could help forming adaptive strategies,while mirtazapine could not.3.CBT,mirtazapine and combined therapy could improve the life quality,reduce symptom severity and unhealthy emotions.While mirtazapine and combined therapies are superior to CBT.