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https://hdl.handle.net/2440/45477
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Type: | Journal article |
Title: | Is there a benefit from intensified medical and psychological interventions in patients with functional dyspepsia not responding to conventional therapy? |
Author: | Haag, S. Senf, W. Tagay, S. Langkafel, M. Braun-Lang, U. Pietsch, A. Heuft, G. Talley, N. Holtmann, G. |
Citation: | Alimentary Pharmacology and Therapeutics, 2007; 25(8):973-986 |
Publisher: | Blackwell Publishing Ltd |
Issue Date: | 2007 |
ISSN: | 0269-2813 1365-2036 |
Statement of Responsibility: | S. Haag, W. Senf, S. Tagay, M. Langkafel, U. Braun-Lang, A. Pietsch, G. Heuft, N. J. Talley and G. Holtmann |
Abstract: | Aim: In a prospective randomized, controlled trial, to compare the long-term outcome of intensive medical therapy (with or without cognitive-behavioural or muscle relaxation therapy) vs. standard medical therapy in patients with refractory functional dyspepsia (FD), referred to a tertiary referral medical center. Methods: A total of 100 consecutive FD patients were allocated to a standardized symptom-oriented 4 month therapy (SMT, n = 24), intensive medical therapy (IMT, medical therapy with testing-for and targeting-of abnormalities of motor-and-sensory function, n = 28) or IMT plus psychological interventions (either progressive-muscle relaxation (IMT-MR, n = 20) or cognitive-behavioural therapy (IMT-CBT, n = 28). The symptom intensity (SI) and health-related quality-of-life (HRQoL) after 12 months were prespecified primary outcome parameters. Results: After 12 months, significantly greater improvement of SI occurred in patients with IMT-all (with or without psychological interventions) compared with SMT (P < 0.025 vs. IMT-all). IMT, IMT-MR and IMT-CBT alone also resulted in significantly better improvement of the primary outcome parameters (P all < 0.025 vs. SMT). HRQoL significantly improved in all groups with intensive medical therapy but not standard medical therapy. Differences between intensive medical therapy-all and standard medical therapy were not significant. Concomitant anxiety and depression was improved significantly by IMT-CBT (vs. SMT) but not other treatments. Conclusions: In FD patients with refractory symptoms, intensified medical management involving function testing and psychological intervention yields superior long-term-outcomes. Additional CBT may be effective for the control of concomitant anxiety and depression. |
Description: | The definitive version is available at www.blackwell-synergy.com Article first published online: 12 FEB 2007 |
Rights: | © 2007 The Authors Journal compilation © 2007 Blackwell Publishing Ltd |
DOI: | 10.1111/j.1365-2036.2007.03277.x |
Published version: | http://dx.doi.org/10.1111/j.1365-2036.2007.03277.x |
Appears in Collections: | Aurora harvest Medicine publications |
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