Effect of acceptance and commitment therapy on psychological symptoms and disease activity in patients with inflammatory bowel disease: A systematic review and meta-analysis - 30/05/26
Highlights |
• | Acceptance and commitment therapy (ACT) led to a significant reduction in anxiety scores compared to the control group. |
• | There were no statistically significant effects on depression, stress, or disease activity overall. |
• | Subgroup analysis showed that ACT significantly improved depression and stress when compared with treatment-as-usual. |
• | Anxiety improvements were evident both immediately post-intervention and at 1–2 months, while stress reduction was significant at 1–2 months. |
Abstract |
Background: Inflammatory Bowel Disease (IBD) negatively impacts quality of life, increasing the risk of psychological disorders. Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that has shown promise for individuals living with chronic illnesses. This meta-analysis aims to explore the efficacy of ACT in managing psychological symptoms in patients with IBD, compared to usual care.
Methods: A systematic search was conducted across PubMed, Web of Science, SCOPUS, CENTRAL, and Google Scholar from inception to August 2025. Eligible studies comprised randomized controlled trials and quasi-experimental studies that compared ACT with usual or other interventions in IBD patients. Standardized Mean Differences (SMDs) with 95% confidence intervals (CIs) were calculated for assessed continuous outcomes. PROSPERO ID: CRD420251153446.
Results: Nine studies involving 459 patients were included. ACT significantly reduced anxiety scores compared to non-ACT (SMD = -0.34; 95% CI: [-0.56 to -0.12]; P < 0.01). Still, the improvements in depression (P = 0.08), stress (P = 0.08), Crohn's disease activity (P = 0.06), and ulcerative colitis activity (P = 0.59) were not statistically significant compared to non-ACT. Subgroup analysis indicated significant improvements in anxiety (SMD = -0.34; 95% CI: -0.64 to -0.03; P = 0.03, I² = 0%), depression (SMD = -0.44; 95% CI: [-0.80 to -0.08]; P = 0.02) and stress (SMD = -0.55; 95% CI: [-0.92 to -0.19]; P < 0.01) scores when ACT was compared with treatment-as-usual. In contrast, no significant differences in depression, anxiety, or stress were found between ACT and other active psychoeducational interventions. Anxiety score was significantly improved post-intervention (SMD = -0.37; 95% CI: [-0.70 to -0.04]; P = 0.03) and at 1–2 months (SMD = -0.33; 95% CI: [-0.63 to -0.03]; P = 0.03), while stress score was significantly improved at 1–2 months (SMD = -0.41; 95% CI: [-0.74 to -0.07]; P = 0.02).
Conclusion: ACT reduced anxiety, depression, and stress versus treatment-as-usual. Additionally, ACT reduced anxiety and stress scores at 1–2 months versus the control group. However, no improvement was observed in CD or UC activity. ACT was not superior to other active controls, such as CBT. Larger, longer follow-up periods and randomized trials are needed to confirm effects on psychological outcomes and disease activity.
Le texte complet de cet article est disponible en PDF.Keywords : Crohn’s disease, Ulcerative colitis, CBT, Psychotherapy, ACT
Abbreviations : IBD, ACT, CD, UC, CBT, HPA, QoL, MBIs, PRISMA, DASS-21, PSS, HBI, short CDAI, SCCAI, RCTs, SMD, CI
Plan
Vol 50 - N° 7
Article 102847- août 2026 Retour au numéro
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