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Managing Pain and Psychosocial Care in IBD: a Primer for the Practicing Gastroenterologist

  • Inflammatory Bowel Disease (M Regueiro, Section Editor)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review focuses on the relationship between trauma and pain in inflammatory bowel disease (IBD), and offers effective treatment strategies.

Recent Findings

Recent evidence points to bidirectional pathways between psychiatric disorders and IBD. The impact of trauma and development of post-traumatic stress symptoms on IBD disease course is beginning to be appreciated including its relationship with pain. First-line treatments for both psychiatric and chronic pain disorders include behavioral interventions such as cognitive behavioral therapy, hypnosis, and mindfulness, and there is emerging evidence studying Acceptance and Commitment Therapy and telehealth interventions. Pharmacological treatments using neuromodulators can also be beneficial. An integrated care team, such as a subspecialty medical home model, can provide the best patient experience and address comprehensive care needs efficiently and effectively.

Summary

Psychosocial factors impact IBD course and necessitate effective management. Despite the significant limitations of research, particularly lack of clinical trials examining behavioral and pharmacotherapy interventions in IBD, effective treatments exist and are best utilized in an integrated care setting.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Lee SH, Kwon JE, Cho ML. Immunological pathogenesis of inflammatory bowel disease. Intest Res. 2018;16:26–42.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Walker JR, Ediger JP, Graff LA, et al. The Manitoba IBD cohort study: a population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders. Am J Gastroenterol. 2008;103:1989–97.

    Article  PubMed  Google Scholar 

  3. Bernstein CN, Hitchon CA, Walld R, et al. Increased burden of psychiatric disorders in inflammatory bowel disease. Inflamm Bowel Dis. 2019;25:360–8.

    Article  PubMed  Google Scholar 

  4. Neuendorf R, Harding A, Stello N, Hanes D, Wahbeh H. Depression and anxiety in patients with inflammatory bowel disease: a systematic review. J Psychosom Res. 2016;87:70–80.

    Article  PubMed  Google Scholar 

  5. Barnes EL, Kochar B, Long MD, Kappelman MD, Martin CF, Korzenik JR, et al. Modifiable risk factors for hospital readmission among patients with inflammatory bowel disease in a Nationwide database. Inflamm Bowel Dis. 2017;23:875–81.

    Article  PubMed  Google Scholar 

  6. Mikocka-Walus A, Pittet V, Rossel JB, et al. Symptoms of depression and anxiety are independently associated with clinical recurrence of inflammatory bowel disease. Clin Gastroenterol Hepatol. 2016;14:829–835.e1.

    Article  PubMed  Google Scholar 

  7. Click B, Ramos Rivers C, Koutroubakis IE, Babichenko D, Anderson AM, Hashash JG, et al. Demographic and clinical predictors of high healthcare use in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2016;22:1442–9.

    Article  PubMed  Google Scholar 

  8. Limsrivilai J, Stidham RW, Govani SM, et al. Factors that predict high health care utilization and costs for patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2017;15:385–392.e2.

    Article  PubMed  Google Scholar 

  9. Persoons P, Vermeire S, Demyttenaere K, et al. The impact of major depressive disorder on the short- and long-term outcome of Crohn's disease treatment with infliximab. Aliment Pharmacol Ther. 2005;22:101–10.

    Article  CAS  PubMed  Google Scholar 

  10. Poojary P, Saha A, Chauhan K, Simoes P, Sands BE, Cho J, et al. Predictors of hospital readmissions for ulcerative colitis in the United States: a national database study. Inflamm Bowel Dis. 2017;23:347–56.

    PubMed  Google Scholar 

  11. van Langenberg DR, Lange K, Hetzel DJ, Holtmann GJ, Andrews JM. Adverse clinical phenotype in inflammatory bowel disease: a cross sectional study identifying factors potentially amenable to change. J Gastroenterol Hepatol. 2010;25:1250–8.

    Article  PubMed  Google Scholar 

  12. Bennebroek Evertsz F, Thijssens NA, Stokkers PC, et al. Do inflammatory bowel disease patients with anxiety and depressive symptoms receive the care they need? J Crohns Colitis. 2012;6:68–76.

    Article  CAS  PubMed  Google Scholar 

  13. Mikocka-Walus A, Knowles SR, Keefer L, et al. Controversies revisited: a systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases. Inflamm Bowel Dis. 2016;22:752–62.

    Article  PubMed  Google Scholar 

  14. Marin-Jimenez I, Gobbo Montoya M, Panadero A, et al. Management of the psychological impact of inflammatory bowel disease: perspective of doctors and patients-the ENMENTE project. Inflamm Bowel Dis. 2017;23:1492–8.

    Article  PubMed  Google Scholar 

  15. Szigethy EM, Allen JI, Reiss M, Cohen W, Perera LP, Brillstein L, et al. White paper AGA: the impact of mental and psychosocial factors on the care of patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2017;15:986–97.

    Article  PubMed  Google Scholar 

  16. Fiest KM, Bernstein CN, Walker JR, et al. Systematic review of interventions for depression and anxiety in persons with inflammatory bowel disease. BMC Res Notes. 2016;9:404.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ballou S, Keefer L. Psychological interventions for irritable bowel syndrome and inflammatory bowel diseases. Clin Transl Gastroenterol. 2017;8:e214.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Park KT, Ehrlich OG. Allen JI, et al. An Initiative From the Crohn's & Colitis Foundation. Inflamm Bowel Dis: The cost of inflammatory bowel disease; 2019.

    Google Scholar 

  19. Marrie RA, Walld R, Bolton JM, et al. Rising incidence of psychiatric disorders before diagnosis of immune-mediated inflammatory disease. Epidemiol Psychiatr Sci. 2019;28:333–42 This study found that the incidence of psychiatric illness is increased 5–10 years prior to IBD and other immune-mediated inflammatory diseases (IMID), and the incidence is substantially increased the year prior to IMID diagnosis. Several hypotheses and directions for future research are discussed, focusing on shared risk factors in IBD and psychiatric illness.

    Article  CAS  PubMed  Google Scholar 

  20. Irwin MR, Miller AH. Depressive disorders and immunity: 20 years of progress and discovery. Brain Behav Immun. 2007;21:374–83.

    Article  CAS  PubMed  Google Scholar 

  21. •• Choi K, Chun J, Han K, et al. Risk of anxiety and depression in patients with inflammatory bowel disease: a nationwide, population-based study. J Clin Med 2019;8.This large-scale study found significantly increased risks of anxiety and depression following IBD diagnosis compared to the general population, particularly in the year following IBD diagnosis.

  22. Keefer L, Kane SV. Considering the bidirectional pathways between depression and IBD: recommendations for comprehensive IBD care. Gastroenterol Hepatol (N Y). 2017;13:164–9.

    Google Scholar 

  23. Bernstein CN. Psychological stress and depression: risk factors for IBD? Dig Dis. 2016;34:58–63.

    Article  PubMed  Google Scholar 

  24. Bonaz BL, Bernstein CN. Brain-gut interactions in inflammatory bowel disease. Gastroenterology. 2013;144:36–49.

    Article  PubMed  Google Scholar 

  25. Regueiro M, Greer JB, Szigethy E. Etiology and treatment of pain and psychosocial issues in patients with inflammatory bowel diseases. Gastroenterology. 2017;152:430–439.e4.

    Article  PubMed  Google Scholar 

  26. Ou G, Bressler B, Galorport C, et al. Rate of corticosteroid-induced mood changes in patients with inflammatory bowel disease: a prospective study. J Can Assoc Gastroenterol. 2018;1:99–106.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bernstein CN. Addressing mental health in persons with IBD. J Can Assoc Gastroenterol. 2018;1:97–8.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Righy C, Rosa RG, da Silva RTA, et al. Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis. Crit Care. 2019;23:213.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Bradford K, Shih W, Videlock EJ, et al. Association between early adverse life events and irritable bowel syndrome. Clin Gastroenterol Hepatol. 2012;10:385–90–e1–3.

    Article  Google Scholar 

  30. Parker CH, Naliboff BD, Shih W, et al. Negative events during adulthood are associated With symptom severity and altered stress response in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 2019.

  31. Camara RJ, Gander ML, Begre S, et al. Post-traumatic stress in Crohn's disease and its association with disease activity. Frontline Gastroenterol. 2011;2:2–9.

    Article  PubMed  Google Scholar 

  32. • Taft TH, Bedell A, Craven MR, et al. Initial assessment of post-traumatic stress in a US cohort of inflammatory bowel disease patients. Inflamm Bowel Dis. 2019;25:1577–85 This study is the first to evaluate post-traumatic stress symptoms in an IBD cohort in the United States. Findings indicate that that a third of IBD patients report significat symptoms associated with post-traumatic stress and have higher rates than an IBS comparison group.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Association AP. Diagnostic and statistical manual of mental disorders: diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  34. PTSD.VA.GOV (2018) Adult PTSD Self-Report Measures. https://www.ptsd.va.gov/professional/assessment/adult-sr/index.asp. Accessed 9 Sept 2019.

  35. Wilkins KC, Lang AJ, Norman SB. Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions. Depression and anxiety. 2011;28:596–606.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Park SH, Videlock EJ, Shih W, Presson AP, Mayer EA, Chang L. Adverse childhood experiences are associated with irritable bowel syndrome and gastrointestinal symptom severity. Neurogastroenterol Motil. 2016;28:1252–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. You DS, Albu S, Lisenbardt H, et al. Cumulative childhood adversity as a risk factor for common chronic pain conditions in young adults. Pain Med. 2019;20:486–94.

    Article  PubMed  Google Scholar 

  38. Drossman DA. Abuse, trauma, and GI illness: is there a link? Am J Gastroenterol. 2011;106:14–25.

    Article  PubMed  Google Scholar 

  39. • Witges KM, Bernstein CN, Sexton KA, et al. The relationship between adverse childhood experiences and health care use in the Manitoba IBD cohort study. Inflamm Bowel Dis 2019.This study found that approximately 75% of an IBD population reported experiencing 1 or more adverse events in childhood (higher than previously believed), and postulates that stressful experiences in childhood could be a risk factor for development of IBD.

  40. Taft TH, Ballou S, Bedell A, et al. Psychological considerations and interventions in inflammatory bowel disease patient care. Gastroenterol Clin N Am. 2017;46:847–58.

    Article  Google Scholar 

  41. Sundman MH, Chen NK, Subbian V, et al. The bidirectional gut-brain-microbiota axis as a potential nexus between traumatic brain injury, inflammation, and disease. Brain Behav Immun. 2017;66:31–44.

    Article  CAS  PubMed  Google Scholar 

  42. Zielinska A, Salaga M, Wlodarczyk M, et al. Focus on current and future management possibilities in inflammatory bowel disease-related chronic pain. Int J Color Dis. 2019;34:217–27.

    Article  Google Scholar 

  43. Carpinelli L, Bucci C, Santonicola A, et al. Anhedonia in irritable bowel syndrome and in inflammatory bowel diseases and its relationship with abdominal pain. Neurogastroenterol Motil. 2019;31:e13531.

    Article  PubMed  Google Scholar 

  44. Zeitz J, Ak M, Muller-Mottet S, et al. Pain in IBD patients: very frequent and frequently insufficiently taken into account. PLoS One. 2016;11:e0156666.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Schirbel A, Reichert A, Roll S, Baumgart DC, Büning C, Wittig B, et al. Impact of pain on health-related quality of life in patients with inflammatory bowel disease. World J Gastroenterol. 2010;16:3168–77.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Morrison G, Van Langenberg DR, Gibson SJ, et al. Chronic pain in inflammatory bowel disease: characteristics and associations of a hospital-based cohort. Inflamm Bowel Dis. 2013;19:1210–7.

    Article  PubMed  Google Scholar 

  47. Srinath A, Young E, Szigethy E. Pain management in patients with inflammatory bowel disease: translational approaches from bench to bedside. Inflamm Bowel Dis. 2014;20:2433–49.

    Article  PubMed  Google Scholar 

  48. •• Sweeney L, Moss-Morris R, Czuber-Dochan W, et al. Systematic review: psychosocial factors associated with pain in inflammatory bowel disease. Aliment Pharmacol Ther. 2018;47:715–29 This review is the first to systematically examine the impact of psychological and social components contributing to pain in an IBD population.

    Article  CAS  PubMed  Google Scholar 

  49. Szigethy E, Knisely M, Drossman D. Opioid misuse in gastroenterology and non-opioid management of abdominal pain. Nat Rev Gastroenterol Hepatol. 2018;15:168–80.

    Article  PubMed  Google Scholar 

  50. Keefer L, Mandal S. The potential role of behavioral therapies in the management of centrally mediated abdominal pain. Neurogastroenterol Motil. 2015;27:313–23.

    Article  CAS  PubMed  Google Scholar 

  51. Teruel C, Garrido E, Mesonero F. Diagnosis and management of functional symptoms in inflammatory bowel disease in remission. World J Gastrointest Pharmacol Ther. 2016;7:78–90.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Colombel JF, Shin A, Gibson PR. AGA clinical practice update on functional gastrointestinal symptoms in patients with inflammatory bowel disease: expert review. Clin Gastroenterol Hepatol. 2019;17:380–390.e1.

    Article  PubMed  Google Scholar 

  53. Mikocka-Walus A, Bampton P, Hetzel D, Hughes P, Esterman A, Andrews JM. Cognitive-behavioural therapy for inflammatory bowel disease: 24-month data from a randomised controlled trial. Int J Behav Med. 2017;24:127–35.

    Article  PubMed  Google Scholar 

  54. McCombie AM, Mulder RT, Gearry RB. Psychotherapy for inflammatory bowel disease: a review and update. J Crohns Colitis. 2013;7:935–49.

    Article  PubMed  Google Scholar 

  55. • Gracie DJ, Irvine AJ, Sood R, et al. Effect of psychological therapy on disease activity, psychological comorbidity, and quality of life in inflammatory bowel disease: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2017;2:189–99 This review and meta-analysis of 14 RCTs of psychological interventions for IBD patients found evidence for benefit of psychiatric therapy, particularly CBT, on depression and quality of life, and highlights research gaps in the treatment of psychological disorders in IBD populations.

    Article  PubMed  Google Scholar 

  56. Thorkelson G, Bielefeldt K, Szigethy E. Empirically supported use of psychiatric medications in adolescents and adults with IBD. Inflamm Bowel Dis. 2016;22:1509–22.

    Article  PubMed  Google Scholar 

  57. Bernstein CN, Zhang L, Lix LM, et al. The validity and reliability of screening measures for depression and anxiety disorders in inflammatory bowel disease. Inflamm Bowel Dis 2018.

  58. IsHak WW, Pan D, Steiner AJ, Feldman E, Mann A, Mirocha J, et al. Patient-reported outcomes of quality of life, functioning, and GI/psychiatric symptom severity in patients with inflammatory bowel disease (IBD). Inflamm Bowel Dis. 2017;23:798–803.

    Article  PubMed  Google Scholar 

  59. • Bennebroek Evertsz F, MAG S, Sitnikova K, et al. Effectiveness of cognitive-behavioral therapy on quality of life, anxiety, and depressive symptoms among patients with inflammatory bowel disease: a multicenter randomized controlled trial. J Consult Clin Psychol. 2017;85:918–25 This randomized controlled trial examined the efficacy of IBD-specific CBT and found it effective in improving quality of life and decreasing anxiety and depression in IBD patients. Recommendations include routine screening of quality of life and offering CBT.

    Article  PubMed  Google Scholar 

  60. Knowles SR, Monshat K, Castle DJ. The efficacy and methodological challenges of psychotherapy for adults with inflammatory bowel disease: a review. Inflamm Bowel Dis. 2013;19:2704–15.

    Article  PubMed  Google Scholar 

  61. Szigethy E, Bujoreanu SI, Youk AO, et al. Randomized efficacy trial of two psychotherapies for depression in youth with inflammatory bowel disease. J Am Acad Child Adolesc Psychiatry. 2014;53:726–35.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Cohen-Mekelburg S, Rosenblatt R, Gold S, et al. The impact of opioid epidemic trends on hospitalized inflammatory bowel disease patients. J Crohns Colitis 2018.

  63. Lee DJ, Schnitzlein CW, Wolf JP, Vythilingam M, Rasmusson AM, Hoge CW. Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: systemic review and meta-analyses to determine first-line treatments. Depress Anxiety. 2016;33:792–806.

    Article  CAS  PubMed  Google Scholar 

  64. Cusack K, Jonas DE, Forneris CA, Wines C, Sonis J, Middleton JC, et al. Psychological treatments for adults with posttraumatic stress disorder: a systematic review and meta-analysis. Clin Psychol Rev. 2016;43:128–41.

    Article  PubMed  Google Scholar 

  65. Kline AC, Cooper AA, Rytwinksi NK, Feeny NC. Long-term efficacy of psychotherapy for posttraumatic stress disorder: a meta-analysis of randomized controlled trials. Clin Psychol Rev. 2018;59:30–40.

    Article  PubMed  Google Scholar 

  66. Watkins LE, Sprang KR, Rothbaum BO, Treating PTSD. A review of evidence-based psychotherapy interventions. Front Behav Neurosci. 2018;12:258.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Peters SL, Muir JG, Gibson PR. Review article: gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease. Aliment Pharmacol Ther. 2015;41:1104–15.

    Article  CAS  PubMed  Google Scholar 

  68. Szigethy E. Hypnotherapy for inflammatory bowel disease across the lifespan. Am J Clin Hypn. 2015;58:81–99.

    Article  PubMed  Google Scholar 

  69. Keefer L, Taft TH, Kiebles JL, Martinovich Z, Barrett TA, Palsson OS. Gut-directed hypnotherapy significantly augments clinical remission in quiescent ulcerative colitis. Aliment Pharmacol Ther. 2013;38:761–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Neilson K, Ftanou M, Monshat K, Salzberg M, Bell S, Kamm MA, et al. A controlled study of a group mindfulness intervention for individuals living with inflammatory bowel disease. Inflamm Bowel Dis. 2016;22:694–701.

    Article  PubMed  Google Scholar 

  71. Hood MM, Jedel S. Mindfulness-based interventions in inflammatory bowel disease. Gastroenterol Clin N Am. 2017;46:859–74.

    Article  Google Scholar 

  72. Korzenik J. Don't worry, be happy: psychological interventions in inflammatory bowel disease. Gastroenterology. 2019;156:856–7.

    Article  PubMed  Google Scholar 

  73. Wynne B, McHugh L, Gao W, et al. Acceptance and commitment therapy reduces psychological stress in patients with inflammatory bowel diseases. Gastroenterology. 2019;156:935–945.e1.

    Article  PubMed  Google Scholar 

  74. Hanlon I, Hewitt C, Bell K, Phillips A, Mikocka-Walus A. Systematic review with meta-analysis: online psychological interventions for mental and physical health outcomes in gastrointestinal disorders including irritable bowel syndrome and inflammatory bowel disease. Aliment Pharmacol Ther. 2018;48:244–59.

    Article  CAS  PubMed  Google Scholar 

  75. Everitt H, Landau S, Little P, Bishop FL, O'Reilly G, Sibelli A, et al. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess. 2019;23:1–154.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Oser ML, Szigethy E, Wallace ML, et al. Randomized adaptive trial of digital behavioral program for anxiety and depression in IBD patient centered medical home. Gastroenterology. 2018;154(6):153.

    Article  Google Scholar 

  77. • Macer BJ, Prady SL, Mikocka-Walus A. Antidepressants in inflammatory bowel disease: a systematic review. Inflamm Bowel Dis. 2017;23:534–50 Of the 15 studies reviewed, most found antidepressants to positively impact IBD course as well as benefit for anxiety and depression levels. Limitations in the research on antidepressants in IBD and recommendations for future research are discussed.

    Article  PubMed  Google Scholar 

  78. Mikocka-Walus A, Prady SL, Pollok J, et al. Adjuvant therapy with antidepressants for the management of inflammatory bowel disease. Cochrane Database Syst Rev. 2019;4:Cd012680.

    PubMed  Google Scholar 

  79. Hall BJ, Hamlin PJ, Gracie DJ, et al. The effect of antidepressants on the course of inflammatory bowel disease. Can J Gastroenterol Hepatol. 2018;2018:2047242.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Goodhand JR, Greig FI, Koodun Y, et al. Do antidepressants influence the disease course in inflammatory bowel disease? A retrospective case-matched observational study. Inflamm Bowel Dis. 2012;18:1232–9.

    Article  CAS  PubMed  Google Scholar 

  81. Yanartas O, Kani HT, Bicakci E, Kilic I, Banzragch M, Acikel C, et al. The effects of psychiatric treatment on depression, anxiety, quality of life, and sexual dysfunction in patients with inflammatory bowel disease. Neuropsychiatr Dis Treat. 2016;12:673–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Kirsch I. Placebo effect in the treatment of depression and anxiety. Front Psychiatry. 2019;10:407.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Drossman DA, Tack J, Ford AC, et al. Neuromodulators for functional gastrointestinal disorders (disorders of gut-brain interaction): a Rome Foundation working team report. Gastroenterology. 2018;154:1140–1171.e1.

    Article  PubMed  Google Scholar 

  84. Urits I, Peck J, Orhurhu MS, et al. Off-label antidepressant use for treatment and management of chronic pain: evolving understanding and comprehensive review. Curr Pain Headache Rep. 2019;23:66.

    Article  PubMed  Google Scholar 

  85. Witkin JM, Martin AE, Golani LK, Xu NZ, Smith JL. Rapid-acting antidepressants. Adv Pharmacol. 2019;86:47–96.

    Article  PubMed  Google Scholar 

  86. Swaminath A, Berlin EP, Cheifetz A, et al. The role of cannabis in the management of inflammatory bowel disease: a review of clinical, scientific, and regulatory information. Inflamm Bowel Dis. 2019;25:427–35.

    Article  PubMed  Google Scholar 

  87. Kafil TS, Nguyen TM, MacDonald JK, et al. Cannabis for the treatment of Crohn's disease. Cochrane Database Syst Rev. 2018;11:Cd012853.

    PubMed  Google Scholar 

  88. Craven MR, Quinton S, Taft TH. Inflammatory bowel disease patient experiences with psychotherapy in the community. J Clin Psychol Med Settings. 2019;26:183–93.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Filipovic BR, Filipovic BF. Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease. World J Gastroenterol. 2014;20:3552–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Kosinski LR, Brill J, Regueiro M. Making a medical home for IBD patients. Curr Gastroenterol Rep. 2017;19:20.

    Article  PubMed  Google Scholar 

  91. Regueiro M, Click B, Holder D, et al. Constructing an inflammatory bowel disease patient-centered medical home. Clin Gastroenterol Hepatol. 2017;15:1148–1153.e4.

    Article  PubMed  Google Scholar 

  92. Regueiro M, Click B, Anderson A, Shrank W, Kogan J, McAnallen S, et al. Reduced unplanned care and disease activity and increased quality of life after patient enrollment in an inflammatory bowel disease medical home. Clin Gastroenterol Hepatol. 2018;16:1777–85.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Szigethy E, Goldblum Y, Weaver E, et al. Reduction of opioid use and depression within an IBD medical home care model. Gastroenterology. 2019;156:S-609–10.

    Article  Google Scholar 

  94. Click B, Regueiro M. The inflammatory bowel disease medical home: From Patients to Populations. Inflamm Bowel Dis 2019.

  95. Bisson JI, Roberts NP, Andrew M, et al. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. 2013;12:CD003388.

    Google Scholar 

  96. Steenkamp M, Roberts PA, Jones N, et al. Psychotherapy for military-related PTSD: a review of randomized clinical trials. J Am Med Assoc. 2015;314:489–500.

    Article  CAS  Google Scholar 

  97. Roberts NP, Roberts PA, Jones N, Bisson JI. Psychological therapies for post-traumatic stress disorder and comorbid substance use disorder. Cochrane Database Syst Rev. 2016;4:CD010204.

    PubMed  Google Scholar 

  98. Khan AM, Dar S, Ahmed R, Bachu R, Adnan M, Kotapati VP. Cognitive behavioral therapy versus eye movement desensitization and reprocessing in patients with post-traumatic stress disorder: systematic review and meta-analysis of randomized clinical trials. Cureus. 2018;10:e3250.

    PubMed  PubMed Central  Google Scholar 

  99. Karatzias T, Murphy P, Cloitre M, et al. Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis. Psych Med. 2019;49:1761–75.

    Article  Google Scholar 

  100. Simblett S, Birch J, Matcham F, Yaguez L, Morris R. A systematic review and meta-analysis of e-mental health interventions to treat symptoms of posttraumatic stress. JMIR Ment Health. 2017;4:e14.

    Article  PubMed  PubMed Central  Google Scholar 

  101. O'Toole SK, Solomon SL, Bergdahl SA. A meta-analysis of hypnotherapeutic techniques in the treatment of PTSD symptoms. J Trauma Stress. 2016;29:97–100.

    Article  PubMed  Google Scholar 

  102. Metcalf O, Varker T, Forbes D, et al. Efficacy of fifteen emerging interventions for the treatment of posttraumatic stress disorder: a systematic review. J Trauma Stress. 2016;29:88–92.

    Article  PubMed  Google Scholar 

  103. Kip KE, Diamond DM. Clinical, empirical, and theoretical rationale for selection of accelerated resolution therapy for treatment of post-traumatic stress disorder in VA and DoD facilities. Milit Med. 2018;183:e314–21.

    Article  Google Scholar 

  104. Gallegos AM, Crean HF, Pigeon WR, Heffner KL. Meditation and yoga for posttraumatic stress disorder: a meta-analytic review of randomized controlled trials. Clin Psych Rev. 2017;58:115–24.

    Article  Google Scholar 

  105. Cramer H, Anheyer D, Saha FJ, Dobos G. Yoga for posttraumatic stress disorder – a systematic review and meta-analysis. BMC Psychiatry. 2018;18:72.

    Article  PubMed  PubMed Central  Google Scholar 

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  1. University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA

    Emily Weaver & Eva Szigethy

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Correspondence to Eva Szigethy.

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Dr. Szigethy reports grants from PCORI, personal fees from APPI, grants from NIH, and personal fees from Janssen outside the submitted work. Ms. Weaver reports nothing to disclose.

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Weaver, E., Szigethy, E. Managing Pain and Psychosocial Care in IBD: a Primer for the Practicing Gastroenterologist. Curr Gastroenterol Rep 22, 20 (2020). https://doi.org/10.1007/s11894-020-0757-7

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