Systematic review, meta-analysis with subgroup analysis of hypnotherapy for irritable bowel syndrome, effect of intervention characteristics.

BACKGROUND: Hypnotherapy has been shown to be effective at relieving global gastrointestinal symptoms (GGS) in irritable bowel syndrome (IBS). This study examines the impact of hypnotherapy delivery and participant characteristics on IBS outcomes. METHODS: This systematic review searched CINAHL, Cochrane Library, Conference Citation Index, Embase, PubMed, PsycARTICLES, PsychINFO, Science Citation index-expanded, Social Science Citation Index. Titles and abstracts, then full-text articles were screened against inclusion criteria: trials with a concurrent comparator of hypnotherapy in adults with IBS diagnosed using Manning or ROME criteria, which provided symptom data. Included studies were extracted and assessed for bias using Cochrane Collaboration 2011 guidance. Random-effects meta-analysis was conducted with sub-group analysis to assess the impact of delivery characteristics on outcomes. RESULTS: Twelve trials were included, 7 in the meta-analyses. Hypnotherapy reduced the risk of GGS, but this was not statistically significant, (standardised mean difference (SMD) 0.24, [-0.06, 0.54], I2 66 %). Higher frequency of sessions (≥1/week) reduced GGS (SMD 0.45 [0.23,0.67] I2 0 %), as did higher volumes of intervention (≥8 sessions with ≥6 h of contact) (SMD 0.51 [0.27,0.76] I2 0 %) and group interventions (SMD 0.45 [0.03, 0.88] I2 62 %). Only volume of intervention produced a significant effect between the subgroups. CONCLUSION: This review suggests that high volume hypnotherapy is more beneficial than low and should be adopted for GDH. Both high frequency and group interventions are effective in reducing GGS in IBS. However, the sample size is small and more studies are needed to confirm this.

How do people with refractory irritable bowel syndrome perceive hypnotherapy?: Qualitative study.

OBJECTIVES: Hypnotherapy is recognised in the UK's National Institute for Health and Care Excellence (NICE) guidelines as a potential treatment for Irritable Bowel Syndrome (IBS). However, little is known about the views of people with IBS regarding hypnotherapy. This qualitative study aimed to identify perceptions of and barriers to hypnotherapy for IBS by people with the condition. DESIGN: One-to-one semi-structured interviews using thematic analysis. SETTING: Convenience sampling in the UK. Participants were recruited by poster advertising and online IBS support groups. Interviews were conducted at the interviewees' preferred location or via video calling. PARTICIPANTS: 17 people (15 female, 2 male) who self-identified as having refractory IBS according to a provided definition. RESULTS: Four hypnotherapy related themes arose from the data: conceptualisation of hypnotherapy, hypnotherapy for IBS, barriers to hypnotherapy for IBS, ideal format of hypnotherapy for IBS. Participants saw hypnosis as an altered state in which change was possible, but many had not considered it for IBS. They were broadly open to hypnotherapy for IBS, but a variety of potential barriers were apparent, including cost and therapist validity. Group hypnotherapy was less acceptable than one-to-one treatment. Hypnotherapy via video call was seen as convenient, but there were concerns about its effectiveness. CONCLUSION: People with IBS may be put off hypnotherapy by a lack of understanding of how it works for their condition and lack of awareness of it as a therapeutic option. Uptake may be improved through effective promotion of the approach which addresses its mechanisms of effect.

What the public think about hypnosis and hypnotherapy: A narrative review of literature covering opinions and attitudes of the general public 1996-2016.

OBJECTIVES: To describe the public's understanding of hypnosis and openness to hypnotherapy. METHODS: A comprehensive search of English language peer reviewed journal articles from 1st January 1996-11th March 2016 was performed over 9 databases (Medline, PubMed, PsycARTICLES, CINAHL, Embase (excerpta medica), PsychInfo, Cochrane, Science citation index-expanded, Conference citation index) and a title-only search of Google scholar. 39 keyword combinations were employed: hypnosis, hypnotherapy, hypnotic, perception, beliefs, knowledge, view, opinion and understanding, in singular and plural where appropriate. A search of the bibliographies of eligible articles was undertaken. Inclusion criteria - Articles containing original data regarding the general public's attitudes towards hypnotherapy or hypnosis. Exclusion criteria - Non-therapy hypnosis (forensic, entertainment) materials and those concerned with groups likely to possess prior or professional knowledge of hypnosis, (hypnotists, clinicians and psychologists). Analysis was conducted in line with the questions. RESULTS: 31 articles were identified, covering diverse populations. Most people believe that: hypnosis is an altered state which requires collaboration to enter; once hypnotized perception changes; hypnotherapy is beneficial for psychological issues and is supportive of medical interventions; hypnosis can also enhance abilities especially memory. People are open to hypnotherapy subject to validation from the psychological or medical establishment. Similarity of opinion is more apparent than difference. CONCLUSION: Most people are positive towards hypnotherapy, and would consider its use under the right circumstances.