Mindfulness-Based Cognitive Therapy for Fatigue in Patients with Inflammatory Bowel Disease: Results of a Randomized Controlled Trial

Abstract

Objectives: Fatigue is a prevalent and burdensome problem in patients with inflammatory bowel disease (IBD), even when the disease is in remission. Evidence-based psychological interventions for managing IBD-related fatigue are still lacking. This study aimed to examine the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) for reducing fatigue in patients with IBD in remission. Method: A two-arm multicenter randomized controlled trial was conducted in 113 IBD outpatients in remission with elevated levels of fatigue (i.e., Checklist Individual Strength — subjective fatigue ≥ 27). Patients were randomly assigned to an 8-week MBCT program (n = 56) or a waiting-list condition (n = 57). All participants completed questionnaires at baseline and directly post-intervention. The primary outcome was fatigue, assessed with the Checklist Individual Strength-20. Secondary outcomes included fatigue interference in daily life, depression, anxiety, and IBD-specific quality of life. Analysis of covariance (ANCOVA) was performed to examine treatment outcomes. Results: Intention-to-treat analyses showed significant reductions in the subjective experience of fatigue in patients receiving MBCT, compared to the waiting-list control condition (p = 0.03; Cohen’s d = 0.46; clinically relevant improvement in 36% vs. 10%). No significant effects were found on other fatigue aspects or secondary outcomes. Conclusions: An 8-week MBCT group program effectively reduced the subjective experience of fatigue in patients with IBD in remission. Results do not support effects for other aspects of fatigue or secondary outcomes. Preregistration: ClinicalTrials.gov Identifier: NCT03162575.