Comparing the Effects of Mindfulness-Based Cognitive Therapy and Cognitive-Behavioral Therapy on Emotion Regulation and Symptoms in Patients with Functional Dyspepsia

Functional Dyspepsia (FD) is the most frequent disorder of the upper gastrointestinal tract. Functional dyspepsia is a biosocial problem. Although the disease does not lead to death, due to frequent clinical manifestations, the necessity to visit a physician, receiving medical care, and absence from work, significantly affect the quality of life in patients. Despite the extant empirical evidence to support the impact of psychological factors on FD, data on available psychological interventions are scarce. Thus, this study aimed to compare the effects of Mindfulness–Based Cognitive Therapy (MBCT) and Cognitive–Behavioral Therapy (CBT) on Emotion Regulation (ER) and symptoms in patients with FD.

This was a quasi–experimental study with a pretest–posttest–follow–up design. This study was conducted in 2017 in Mashhad City, Iran. The statistical population consisted of all patients referring to the Gastroenterology Clinic of the Ghaem Hospital who received a definitive diagnosis of FD by gastroenterologists after the laboratory tests and endoscopic examination. The study sample consisted of 30 patients who were selected by convenience sampling method according to the inclusion criteria; they were randomly divided into two equal experimental groups. The inclusion criteria of the study were the age range of 18–55 years, a definitive diagnosis of FD by a gastroenterologist, laboratory tests and endoscopic examination, no diseases, such as cancer and gastric ulcers, treating Helicobacter pylori infection, and Helicobacter pylori eradication therapy, literacy to complete the questionnaire, consent to participate in the research, and no other serious biopsychological illnesses. The exclusion criteria included generating other serious biopsychological conditions, and no consent to participate in the research. The research patients were randomly placed into the experimental groups of MBCT and CBT. MBCT and CBT were administered in eight 120–min weekly sessions. CBT and MBCT were performed as per Beck’s package (2001) and Segal et al.’s package (2013), respectively. The Cognitive Emotion Regulation Questionnaire (Garnefski et al., 2001) and the Nepean Dyspepsia Index (Talley et al., 1999) were employed to evaluate FD symptoms in pretest, posttest, and follow–up steps. The follow–up stage was performed 2 months after the posttest stage. The obtained data were analyzed using repeated–measures Analysis of Variance (ANOVA) and Bonferroni post hoc test in SPSS at a significance level of 0.05.

The obtained results suggested that the intragroup factor (time) was significant for FD and ER (p<0.001). Additionally, the intergroup factor and the time*group interaction were significant for FD and ER (positive & negative ER strategies) (p<0.001). In the MBCT group, the mean scores of FD significantly decreased from 56.66 in the pretest to 46.53 and 48.06 in the posttest and follow–up, respectively. However, in the CBT group, a smaller decrease was observed. In the MBCT group, the mean scores of positive ER strategies significantly increased from 46.13 in the pretest to 74.40 and 67.40 in the posttest and follow–up, respectively. However, in the CBT group, this increase was less. In the MBCT group, the scores of negative ER strategies significantly decreased from 50.06 in the pretest to 37.86 and 41.46 in the posttest and follow–up, respectively. However, in the CBT group, a smaller decrease was observed. There was a significant difference in the mean values of FD and ER between the pretest, posttest, and follow–up stages (p<0.001). Additionally, a significant difference was observed between the posttest and follow–up stages in the mentioned variables, indicating that the effects of the intervention were not permanent in the follow–up stage (p<0.001).

According to the present study data, MBCT was more effective than CBT in decreasing FD symptoms and improving ER in patients with FD.