Kivonat:
Inflammatory bowel disease (Crohn's disease and colitis
ulcerosa) is a chronic, long-term condition that causes
chronic inflammation in the digestive tract, and shows an
increasing incidence and prevalence worldwide. Changes in
disease activity over time affect psychological distress
which increases the risk of exacerbations. Beside somatic
symptoms (such as abdominal pain, diarrhoea and weight loss),
psychiatric comorbidity (in particular major depression,
anxiety, social phobia) is common in patients with Crohn's
disease. This case study illustrates the management and
stabilization of a 21-year-old adult male patient with
active Crohn's disease and with severe psychiatric
comorbidity. The patient was diagnosed with avoidant
personality disorder and dysruptive mood dysregulation
disorder based on the results of psychodiagnostics (SCID-II
structured clinical interview, MMPI personality inventory and
disease-specific clinical questionnaires such as Beck
Depression Inventory, Beck Hopelessness Scale, Social
Cognition Questionnaire, Anger Expression Scale, Cognitive
Emotion Regulation Questionnaire, Rosenberg Self-Esteem
Scale). The main aim of psychotherapy is to increase the
adherence to pharmacotherapy, to promote psychosocial
functioning, to improve well-being and to enhance adaptive
coping strategies. Low-intensity cognitive-behavioural
psychotherapy was used which included psychoeducation,
motivational interview, behavioural activation, patient
diary, cognitive restructuring, problem-solving training, and
family consulting. Twenty-five sessions were held weekly in
outpatient form and 3 sessions of crisis intervention after
the surgery at the hospital. The efficacy of the treatment
was measured by self-reported questionnaires at baseline and
at two follow-up sessions which corroborated a very
significant decrease in the severity of depression,
hopelessness, while emotional regulation and self-esteem
became more adaptive. The remission of the above-mentioned
psychiatric symptoms resulted in the improvement of the
pharmacotherapy adherence and the quality of life. Low-
intensity psychosocial interventions are proven to be an
effective way of delivering evidence-based psychotherapy. Orv
Hetil. 2018; 159(9): 363-369.