Targeting the gut-brain axis for therapeutic adherence in patients with inflammatory bowel disease: a review on the role of psychotherapy

Abstract

Purpose Inflammatory Bowel Diseases (IBD) are disorders intensively studied in the literature as a model of gut-brain interactions within the so-called gut-brain axis. A non-negligible proportion of patients with IBD have psychological and psychiatric comorbidities and show non-low levels of depressive and anxiety symptoms. The remitting-recurrent course of IBD poses the need for therapeutic intervention that not only serves to induce clinical remission of the disease but also has an impact on maintenance. Therefore, therapeutic adherence is undoubtedly a cornerstone of managing these patients. Material and methods A literature search was conducted to identify studies with psychotherapy as an intervention and therapeutic adherence to IBD-specific therapy as one of the outcomes. Results Not many studies in the literature have specifically explored the role of psychotherapy in improving therapeutic adherence in patients with IBD. Most of the available trials have focused on cognitive-behavioral psychotherapeutic interventions and are directed toward basically oral therapies. Other studies focused on interventions delivered under telemedicine or mindfulness or hypnotherapy techniques. Conclusions This narrative review leans toward a probable beneficial effect of psychotherapy in therapeutic adherence although new and more organic studies need to be conducted to generate stronger evidence.

Keywords

• ulcerative colitis
• crohn’s disease
• gut-brain axis
• psychotherapy