Abstract Background Fatigue affects up to 70% of patients with inflammatory bowel disease (IBD), even in remission, and remains a major unmet need. Few active interventions specifically target this symptom. Solution-focused brief therapy (SFBT) is a short-term, goal- and resource-oriented psychotherapeutic approach that encourages autonomy, self-efficacy, and engagement. This study evaluated the impact of SFBT on fatigue, anxiety, depression, sleep quality, and wellbeing in IBD, and explored predictors of response and adherence. Methods Prospective, interventional, single-centre, uncontrolled study including adults with IBD and fatigue (Inflammatory Bowel Disease Fatigue score IBD-F 1), stable IBD treatment for ≥3 months, and no corticosteroids. Fatigue (IBD-F1 and IBD-F2), anxiety and depression (Hospital Anxiety and Depression Scale HADS), sleep quality (Pittsburgh Sleep Quality Index PSQI) and wellbeing (Subjective Happiness Scale SHS) were assessed before and after SFBT. Therapy was delivered by a single trained therapist in 3–6 sessions, depending on individual progression. Adherence was considered complete when all sessions were attended and null when discontinued after the first. Results Sixty-seven patients were screened; six were referred for psychiatric management and eleven discontinued early. Fifty were analysed (68% female; median age 43 years; 65% Crohn’s disease). IBD-F1 correlated with SHS (r = 0.52, p 0.0001), PSQI (r = 0.37, p = 0.0029), and HADS (r = 0.65, p 0.0001). SFBT significantly improved IBD-F1 (p 0.0001), IBD-F2 (p 0.0001), HADS (p 0.0001), PSQI (p = 0.0001), and SHS (p 0.0001). Fatigue reduction was associated with female sex (p = 0.017), Montreal E1 vs E3 (p = 0.009), higher baseline IBD-F1 (p = 0.025) and lower body weight (p = 0.010). Reduced fatigue impact was linked to higher HADS (p = 0.012), perianal disease (p = 0.032) and absence of remission (p = 0.001). Complete adherence (71.6%) was associated with psychiatric follow-up (p = 0.001), antidepressant use (p = 0.006), shorter disease duration (p = 0.023), absence of follow-up during the COVID period (p = 0.035), and higher baseline fatigue (p = 0.017). Conclusion SFBT significantly improved fatigue, anxiety, depression, sleep, and quality of life in IBD, including in patients not in remission. These findings suggest that SFBT may represent a valuable integrative approach for IBD-related fatigue. Controlled multicentre trials are warranted to confirm efficacy and define optimal patient selection. Conflict of interest: Collin, Julie: No conflict of interest Moor, Laurent: Grant: Ferring, Janssen, Takeda, Fresenius, Biogen Personal Fees: Ferring, Janssen, Takeda, Fresenius, Abbvie, Galapagos, Pfizer, Celltrion, Thermofisher, BMS, Lilly, Thermofisher Monin, Lucie: No conflict of interest Latour, Pascale: No conflict of interest Van Kemseke, Catherine: No conflicts Vieujean, Sophie: No conflict of interest Louis, Edouard: Education and Reserach Grants for my department: Abbvie, Takeda, Johnson and Johnson, Pfizer, Fresenius-Kabi, Celltrion, EG pharma, Sandoz, Falk Personal Fees for conferences, advisory boards and consultancy: Abbvie, Takeda, Ferring, Pfizer, Johnson and Johnson, Lilly, Galapagos, Celltrion, Arena, BMS, Falk, Biokuris, Fresenius-Kabi, Thabor Prof. Dr. Reenaers, Catherine: This work supported by a grant from Takeda
Collin et al. (Thu,) studied this question.
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