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Functional dyspepsia (FD)is defined as the presence of symptoms thought to originate in the gastroduodenal region with no evidence of structural disease that is likely to explain the symptoms. The cause of this condition is unclear, not being a recognized treatment for it. The conventional treatments for those patients are symptom based. Unfortunately, these medications are not very effective. Patients with FD report poorer health status, mental health, and social functioning than patients with structural gastrointestinal pathology. Our aim is to compare a combined intervention (medical plus psychological intervention) versus conventional intervention (medical intervention)in regard to the health related quality of life, symptomatology, anxiety and depression of those patients. The investigators hypothesized that compared with conventional intervention a combined intervention would yield significantly better short (after treatment) and medium term (six months after treatment) improvement of health related quality of life and symptoms.
Patients were recruited from the digestive services of Galdakao-Usansolo and Basurto hospitals. They were randomly allocated to the control or experimental group. 82 patients were included in the control group and 76 in the experimental group.
Regarding the intervention, the treatment of the control group was a conventional (medical) intervention. It was focused on the most bothersome symptom. Prokinetic (for example cinitapride) or antisecretory agent (for example omeprazole) was prescribed in standard dose. Experimental group received the combined intervention (medical plus psychological intervention). The psychological support consisted of ten weekly sessions, which the first 8 were in group and the last 2 were individuals. In those sessions the patients received a) an information session to increase the patients' knowledge of functional dyspepsia; b) a Beck's cognitive-behavioural therapy focused on modifying the influence of some cognitive issues to gastrointestinal symptoms; c) and progressive-muscle relaxation according to Jacobson, with the aim to provide the ability to relax in certain stress situations. This technique was created for reducing anxiety by alternately tensing and relaxing the muscles.
All the patients completed all the self questionnaires at baseline (t0), at the end of the treatment (T1) and at six months follow up (T2). The health related quality of life was assessed by the Dyspepsia Related Health Scale (DRHS), and anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Finally, the subjective clinical improvement was also considered and it was measured by a question about how they feel in regard to the functional dyspepsia, with five alternatively responses (a) Much better, b) quite a lot better, c) somewhat better, d) about the same, e) somewhat worse, f) quite a lot worse, g) much worse).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Psychological support | Experimental | Ten weekly sessions, which the first 8 were in group and the last 2 were individuals. It consists on a) an informational session; b) Beck's cognitive-behavioural therapy; and c) progressive-muscle relaxation according to Jacobson |
|
| No psychological support | Active Comparator | Patients of this group only received the conventional medical treatment, not receiving any psychological support |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Psychological support | Behavioral |
| ||
| No intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in DYSPEPSIA RELATED HEALTH SCALE (DRHS) | The Dyspepsia Related Health Scale (DRHS) is a self-reported dyspepsia-specific questionnaire that consists of four scales: severity of common symptoms, pain intensity, pain disability, and satisfaction with dyspepsia-related health. The score, for each scale, ranges between 0 and 100, with 0 representing the most severe situation and 100 the least severe. It also yields a global score that ranges from 0 to 100, with higher scores indicating less severe dyspepsia. The adapted and validated Spanish version of this questionnaire is known as QoL-PEI (Quality of Life in relation to Stomach and Intestinal Problems Questionnaire). Its reliability was found to be satisfactory (Cronbach's alpha 0.92). Its factorial analysis confirmed the four scales found by the DRHS but added a global score scale. The convergent validity was moderate (0.54). | Participants will be followed at the recruit moment (t0) after treatment (t1) and six months after treatment (t2) |
| Measure | Description | Time Frame |
|---|---|---|
| Subjective Clinical Improvement | Subjective clinical improvement was measured by a question about how patients feel in regard to the functional dyspepsia ("In relation to functional dyspepsia, how would you rate your health now? a)much better; b) quite a lot better; c) somewhat better; d) about the same; e) somewhat worse; f) quite a lot worse; g) much worse | Subjective clinical improvement it is measured after treatment (t1) and six months after treatment (t2) |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital Anxiety and Depression Scale | It is a 14-item measure: 7 items evaluate depression (the HADS-D subscale) and 7 evaluate anxiety (the HADS-A subscale). For each subscale items range from 0 to 21. A subscale score of 0-7 indicates the absence of anxiety or depression; a score of 8-10 indicates a possible case of anxiety or depression; and a score of 11 or higher indicates the presence of anxiety or depression. It has been adapted and validated in a Spanish population |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Victor Manuel Orive, Doctor | Basurto University Hospital | Principal Investigator |
| Jose Luis Cabriada, Doctor | Hospital Galdakao-Usansolo | Study Chair |
| Aitor Orive, Doctor | Hospital Galdakao-Usansolo | Study Chair |
| Begoña Matellanes, Psychology | University of Deusto | Study Chair |
| Maria Josefa Ulloa, Nurse | Basurto University Hospital | Study Chair |
| Jesus Angel Padierna, Doctor | Hospital Galdakao-Usansolo | Study Chair |
| Antonio Escobar, Doctor | Basurto University Hospital | Study Chair |
| Antonio Bernal, Doctor | Hospital Galdakao-Usansolo | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Galdakao-Usansolo Hospital | Usansolo | Bizkaia | 48960 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25791668 | Result | Orive M, Barrio I, Orive VM, Matellanes B, Padierna JA, Cabriada J, Orive A, Escobar A, Quintana JM. A randomized controlled trial of a 10 week group psychotherapeutic treatment added to standard medical treatment in patients with functional dyspepsia. J Psychosom Res. 2015 Jun;78(6):563-8. doi: 10.1016/j.jpsychores.2015.03.003. Epub 2015 Mar 11. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Psychological Support | Ten weekly sessions, which the first 8 were in group and the last 2 were individuals. It consists on a) an informational session; b) Beck's cognitive-behavioural therapy; and c) progressive-muscle relaxation according to Jacobson Psychological support + conventional medical treatment |
| FG001 | No Psychological Support | Patients of this group only received the conventional medical treatment, not receiving any psychological support Only conventional medical treatment |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| From T0 to T1 |
| |||||||||||||
| From T1 to T2 |
|
In certain analyzes we lose some subjects, for example when studying Subjective Clinical Improvement (here we have 60 patients in the experimental group and 69 in the control group)
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| ID | Title | Description |
|---|---|---|
| BG000 | Psychological Support | Ten weekly sessions, which the first 8 were in group and the last 2 were individuals. It consists on a) an informational session; b) Beck's cognitive-behavioural therapy; and c) progressive-muscle relaxation according to Jacobson Psychological support + conventional medical treatment |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in DYSPEPSIA RELATED HEALTH SCALE (DRHS) | The Dyspepsia Related Health Scale (DRHS) is a self-reported dyspepsia-specific questionnaire that consists of four scales: severity of common symptoms, pain intensity, pain disability, and satisfaction with dyspepsia-related health. The score, for each scale, ranges between 0 and 100, with 0 representing the most severe situation and 100 the least severe. It also yields a global score that ranges from 0 to 100, with higher scores indicating less severe dyspepsia. The adapted and validated Spanish version of this questionnaire is known as QoL-PEI (Quality of Life in relation to Stomach and Intestinal Problems Questionnaire). Its reliability was found to be satisfactory (Cronbach's alpha 0.92). Its factorial analysis confirmed the four scales found by the DRHS but added a global score scale. The convergent validity was moderate (0.54). | the number analyzed in the rows differs from overall number analyzed because, as it is occur in follow-up studies, patients were lost from T0 to T1. | Posted | Mean | Standard Deviation | units on a scale | Participants will be followed at the recruit moment (t0) after treatment (t1) and six months after treatment (t2) |
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"0" Total Number of Participants at Risk: All-Cause Mortality, Serious and other adverse events were not monitored/assessed
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Psychological Support | Ten weekly sessions, which the first 8 were in group and the last 2 were individuals. It consists on a) an informational session; b) Beck's cognitive-behavioural therapy; and c) progressive-muscle relaxation according to Jacobson Psychological support |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dra Miren Orive | Hospital Galdakao-Usansolo | 0034 944007105 | miren.orivecalzada@osakidetza.net |
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|
| Participants will be followed at the recruit moment (t0) after treatment (t1) and six months after treatment (t2) |
| NOT COMPLETED |
|
| No Psychological Support |
Patients of this group only received the conventional medical treatment, not receiving any psychological support No psychological intervention |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| ID | Title | Description |
|---|
| OG000 | Psychological Support | Ten weekly sessions, which the first 8 were in group and the last 2 were individuals. It consists on a) an informational session; b) Beck's cognitive-behavioural therapy; and c) progressive-muscle relaxation according to Jacobson Psychological support + conventional medical treatment |
| OG001 | No Psychological Support | Patients of this group only received the conventional medical treatment, not receiving any psychological support No psychological intervention |
|
|
| Secondary | Subjective Clinical Improvement | Subjective clinical improvement was measured by a question about how patients feel in regard to the functional dyspepsia ("In relation to functional dyspepsia, how would you rate your health now? a)much better; b) quite a lot better; c) somewhat better; d) about the same; e) somewhat worse; f) quite a lot worse; g) much worse | Posted | Count of Participants | Participants | Subjective clinical improvement it is measured after treatment (t1) and six months after treatment (t2) |
|
|
|
| Other Pre-specified | Hospital Anxiety and Depression Scale | It is a 14-item measure: 7 items evaluate depression (the HADS-D subscale) and 7 evaluate anxiety (the HADS-A subscale). For each subscale items range from 0 to 21. A subscale score of 0-7 indicates the absence of anxiety or depression; a score of 8-10 indicates a possible case of anxiety or depression; and a score of 11 or higher indicates the presence of anxiety or depression. It has been adapted and validated in a Spanish population | The number analyzed in the rows differs from overall number analyzed because, as it is occur in follow-up studies, patients were lost from T0 to T2. | Posted | Mean | Standard Deviation | units on a scale | Participants will be followed at the recruit moment (t0) after treatment (t1) and six months after treatment (t2) |
|
|
|
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | No Psychological Support | Patients of this group only received the conventional medical treatment, not receiving any psychological support No intervention | 0 | 0 | 0 | 0 |
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| From t0 to t2in HADS-D |
|
|