Psychological interventions improve mental health in inflammatory digestive diseases:
a systematic review and meta-analysis of randomized controlled trials
Inflammatory digestive diseases can majorly impact the physical and mental well-being
of affected patients.This meta-analysis aimed to assess the efficacy of psychological
interventions (including psychotherapy, mindfulness, cognitive-behavioral therapy,
relaxation techniques, meditation, stress management, self-help strategies, psychoeducation,
motivational interviewing, hypnotherapy, solution-based therapy, and counseling) on
mental parameters and disease-related outcomes in this population.This was a systematic
review and meta-analysis.The systematic search was conducted on July 31, 2025. Randomized
controlled trials (RCTs) were eligible. Outcomes were assessed at the end of therapy
and at various time points during the follow-up period (short-, mid-, and long-term
follow-up). Owing to the differences in scales and questionnaires, the standardized
mean difference (SMD) was used to pool effect sizes, along with corresponding 95%
confidence interval (CI). Higgins and Thompson's I2 statistics were used to assess
heterogeneity.We included 24 RCTs that investigated the effect of psychological interventions
on depressive symptoms in inflammatory digestive diseases, totaling 1572 participants.
The pooled analysis found that psychological interventions resulted in a moderate
reduction of depression compared to controls (SMD -0.46; CI: -0.75; -0.18). Data from
19 RCTs with 1593 patients also demonstrated a moderate reduction in anxiety symptoms
in subjects undergoing psychological interventions (SMD -0.58; CI: -0.94; -0.22).
The pooled analysis of 13 RCTs with 772 participants found that psychological therapy
was associated with a moderate decrease in stress (SMD -0.53; CI: -1.04; -0.03). The
additional analysis of follow-up data showed that benefits resulting from treatment
gradually decreased, showing no significant difference at the end of the long-term
follow-up period.Psychological interventions effectively improve mental health-related
outcomes in patients with inflammatory digestive diseases. Since benefits from therapy
seem to decrease during the follow-up period, repeated interventions may be necessary.The
study protocol was prospectively registered on PROSPERO (CRD42021282965).