Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3446-3462
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3446
Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients
Shi-Rui Zhao, Xiao-Mei Ni, Xin-An Zhang, Hong Tian
Shi-Rui Zhao, Xin-An Zhang, College of Kinesiology, Shenyang Sport University, Shenyang 110102, Liaoning Province, China
Xiao-Mei Ni, Department of Psychotherapy and Counseling, Shenyang Mental Health Center, Shenyang 110168, Liaoning Province, China
Hong Tian, Department of Digestion, The 4th People’s Hospital of Shenyang, Shenyang 110031, Liaoning Province, China
Author contributions: Zhang XA and Zhao SR designed research; Zhao SR, Ni XM and Tian H performed research; Ni XM and Zhang XA contributed new reagents or analytic tools; Zhao SR and Tian H analyzed data; Zhang XA and Zhao SR wrote the paper.
Supported by the National Nature Science Foundation of China, No. 81572243; and Scientific Research Funds Project of Liaoning Education Department, No. LJC2019ST02.
Institutional review board statement: The study was approved Program of China, No. 2018-KY-2-003.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at zhangxa2725@163.com. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-An Zhang, MD, Associate Professor, College of Kinesiology, Shenyang Sport University, 36 Jinqiansong East Road, Sujiatun District, Shenyang 110102, Liaoning Province, China. zhangxa2725@163.com
Telephone: +86-13591433526 Fax: +86-24-89166630
Received: July 2, 2019
Peer-review started: July 12, 2019
First decision: August 2, 2019
Revised: August 10, 2019
Accepted: September 13, 2019
Article in press: September 13, 2019
Published online: November 6, 2019
Processing time: 130 Days and 1.5 Hours
ARTICLE HIGHLIGHTS
Research background

Compared with organic gastroenteropathy, irritable bowel syndrome (IBS) is more prone to cognitive bias and emotional disorders, which can lead to "abnormal" psychological behavior patterns. IBS can affect the nervous system function of patients through hypothalamus-pituitary-adrenal axis and so on, cause increased vagus nerve excitability, stimulate intestinal peristalsis and mucosal gland secretion, and cannot relieve gastrointestinal symptoms. Therefore, it is very important to correct patients' cognitive biases and coping styles for the fundamental treatment of diseases.

Research motivation

Studies have confirmed that IBS patients generally have cognitive biases and negative coping styles, accompanied by negative emotions. Clinically, the improvement of symptoms is often limited to drugs or single CBT therapy. However, if the treatment strategy of combining mental psychology and body cannot be adopted in a way of both body and mind, it is difficult to realize the integrated regulation of brain-intestine axis, and the disease cannot be fundamentally solved. According to some research reports, exercise can improve the mood of IBS patients. Therefore, on the basis of cognitive behavioral therapy, exercise therapy is used as an auxiliary therapy to correct the cognitive bias of patients and produce positive coping styles, which may be an important strategy for rehabilitation treatment of IBS.

Research objectives

The research objective of this study was to explore the effect of cognitive behavioral therapy combined with exercise intervention on cognitive bias and coping styles of patients with diarrhea-predominant IBS to provide a theoretical reference for the prevention and treatment of diarrhea-predominant IBS.

Research methods

We retrospectively analyzed 60 patients with diarrhea-predominant IBS aged 30-40 years and 30 healthy subjects recruited from January 2018 to October 2018. They were randomly divided into the experimental group and the control group. All subjects received 24 wk of continuous intervention program. Statistical analysis was conducted through repeated measurement variance analysis, and correlation and regression analysis were used to determine correlation.

Research results

Our study found that patients with IBS have obvious cognitive bias and negative coping styles compared with normal people. IBS-SSS symptom score is significantly correlated with ATQ, DAS and CSQ scores.

Research conclusions

Cognitive behavioral therapy combined with exercise intervention can well correct the cognitive bias of diarrhea IBS patients and eliminate the adverse coping conditions of patients, which is of great significance for the treatment of IBS and psychosomatic diseases.

Research perspectives

The number of subjects included in our study is relatively small, the intervention time is relatively short, and there are not enough observation indicators to more fully reflect the clinical situation of patients. In future research, more attention should be paid to the above deficiencies.