Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy?
Aliment Pharmacol Ther
; 25(8): 973-86, 2007 Apr 15.
Article
en En
| MEDLINE
| ID: mdl-17403002
ABSTRACT
AIM:
In a prospective randomized, controlled trial, to compare the long-term outcome of intensive medical therapy (with or without cognitive-behavioural or muscle relaxation therapy) vs. standard medical therapy in patients with refractory functional dyspepsia (FD), referred to a tertiary referral medical center.METHODS:
A total of 100 consecutive FD patients were allocated to a standardized symptom-oriented 4 month therapy (SMT, n = 24), intensive medical therapy (IMT, medical therapy with testing-for and targeting-of abnormalities of motor-and-sensory function, n = 28) or IMT plus psychological interventions (either progressive-muscle relaxation (IMT-MR, n = 20) or cognitive-behavioural therapy (IMT-CBT, n = 28). The symptom intensity (SI) and health-related quality-of-life (HRQoL) after 12 months were prespecified primary outcome parameters.RESULTS:
After 12 months, significantly greater improvement of SI occurred in patients with IMT-all (with or without psychological interventions) compared with SMT (P < 0.025 vs. IMT-all). IMT, IMT-MR and IMT-CBT alone also resulted in significantly better improvement of the primary outcome parameters (P all < 0.025 vs. SMT). HRQoL significantly improved in all groups with intensive medical therapy but not standard medical therapy. Differences between intensive medical therapy-all and standard medical therapy were not significant. Concomitant anxiety and depression was improved significantly by IMT-CBT (vs. SMT) but not other treatments.CONCLUSIONS:
In FD patients with refractory symptoms, intensified medical management involving function testing and psychological intervention yields superior long-term-outcomes. Additional CBT may be effective for the control of concomitant anxiety and depression.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Terapia Cognitivo-Conductual
/
Terapia por Relajación
/
Dispepsia
/
Antiulcerosos
/
Antidepresivos
Tipo de estudio:
Clinical_trials
/
Etiology_studies
Aspecto:
Patient_preference
Límite:
Adult
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Aliment Pharmacol Ther
Asunto de la revista:
FARMACOLOGIA
/
GASTROENTEROLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2007
Tipo del documento:
Article
País de afiliación:
Alemania