Home›Psychiatry› Acceptance and Commitment Therapy reduces anxiety, depression, and stress in patients with inflammatory bowel disease
Acceptance and Commitment Therapy reduces anxiety, depression, and stress in patients with inflammatory bowel diseaseAcceptance and Commitment Therapy reduces anxiety for inflammatory bowel disease
Clinics and research in hepatology and gastroenterologyPublished August 1, 2026Study authors: Saleh Ahmad Omar, Hawas Yousef, Mahmoud Mohamed H, Haseeb Mohamed E, Nasser Mohamed, Al-Majali Lojai…PubMed ↗DOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Consider Acceptance and Commitment Therapy to reduce anxiety, depression, and stress in patients with inflammatory bowel disease.
This meta-analysis evaluated the efficacy of Acceptance and Commitment Therapy (ACT) in patients with inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, compared to treatment-as-usual and other active psychoeducational interventions. The study included 459 patients across various designs, including randomized trials and quasi-experimental studies.
Findings indicated that ACT significantly reduced anxiety scores (SMD = -0.34) compared to non-ACT groups. When compared specifically to treatment-as-usual, ACT showed significant improvements in anxiety (SMD = -0.34), depression (SMD = -0.44), and stress (SMD = -0.55). However, when compared against other active psychoeducational interventions like CBT, ACT did not show statistically significant improvements for anxiety, depression, or stress.
Regarding physical disease markers, the meta-analysis found no statistically significant differences in Crohn's disease activity (P = 0.06) or ulcerative colitis activity (P = 0.59) when comparing ACT to non-ACT interventions. The authors noted several limitations, including the need for larger study populations, longer follow-up periods, and more randomized trials to confirm effects on actual disease activity.
Clinically, ACT may be a viable option for managing psychological symptoms in IBD patients. However, its superiority over other established psychoeducational methods like CBT is not supported by current data.
How this fits prior evidence
This meta-analysis extends the evidence regarding non-pharmacological management of psychological comorbidities in inflammatory bowel disease. It builds upon findings that exercise-based and mind-body movement interventions significantly reduce depressive symptoms in patients with inflammatory bowel disease. While this study confirms that ACT is effective for reducing anxiety, depression, and stress compared to treatment-as-usual, it does not provide evidence of superiority over other active psychoeducational interventions.
Living with Inflammatory Bowel Disease (IBD) involves more than just physical discomfort. The constant cycle of flare-ups and management often leads to heavy emotional burdens like chronic stress and anxiety. New data suggests a specific type of psychological support might help manage these mental hurdles.
A review of 459 patients showed that Acceptance and Commitment Therapy (ACT) significantly reduced anxiety, depression, and stress when compared to standard care. While ACT was more effective than basic treatment-as-usual, it did not show significant advantages over other active therapies like Cognitive Behavioral Therapy (CBT).
It is important to note that while the mental health benefits were clear, the study did not find evidence that ACT changed the physical activity of Crohn's disease or ulcerative colitis. Because the follow-up period was short and the sample size was limited, more research is needed to see how these results hold up over time.
What this means for you:
Acceptance and Commitment Therapy significantly reduces anxiety, stress, and depression in patients with inflammatory bowel disease.
Common questions
Can this therapy help my mental health if I have Crohn's?
Yes. The study found that Acceptance and Commitment Therapy (ACT) significantly reduced anxiety, stress, and depression scores for patients with inflammatory bowel disease compared to standard care.
Does this treatment improve the physical symptoms of my condition?
The data did not show a statistically significant difference in Crohn's disease activity or ulcerative colitis activity when using ACT compared to other treatments. It specifically targeted psychological symptoms like anxiety and stress.
How is it different from other types of therapy?
While ACT was more effective than standard care, the study found it was not significantly better than other active psychoeducational interventions, such as Cognitive Behavioral Therapy (CBT).
BACKGROUND: Inflammatory Bowel Disease (IBD) negatively impacts quality of life, increasing the risk of psychological disorders. Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that has shown promise for individuals living with chronic illnesses. This meta-analysis aims to explore the efficacy of ACT in managing psychological symptoms in patients with IBD, compared to usual care.
METHODS: A systematic search was conducted across PubMed, Web of Science, SCOPUS, CENTRAL, and Google Scholar from inception to August 2025. Eligible studies comprised randomized controlled trials and quasi-experimental studies that compared ACT with usual or other interventions in IBD patients. Standardized Mean Differences (SMDs) with 95% confidence intervals (CIs) were calculated for assessed continuous outcomes.
PROSPERO ID: CRD420251153446.
RESULTS: Nine studies involving 459 patients were included. ACT significantly reduced anxiety scores compared to non-ACT (SMD = -0.34; 95% CI: [-0.56 to -0.12]; P < 0.01). Still, the improvements in depression (P = 0.08), stress (P = 0.08), Crohn's disease activity (P = 0.06), and ulcerative colitis activity (P = 0.59) were not statistically significant compared to non-ACT. Subgroup analysis indicated significant improvements in anxiety (SMD = -0.34; 95% CI: -0.64 to -0.03; P = 0.03, I² = 0%), depression (SMD = -0.44; 95% CI: [-0.80 to -0.08]; P = 0.02) and stress (SMD = -0.55; 95% CI: [-0.92 to -0.19]; P < 0.01) scores when ACT was compared with treatment-as-usual. In contrast, no significant differences in depression, anxiety, or stress were found between ACT and other active psychoeducational interventions. Anxiety score was significantly improved post-intervention (SMD = -0.37; 95% CI: [-0.70 to -0.04]; P = 0.03) and at 1-2 months (SMD = -0.33; 95% CI: [-0.63 to -0.03]; P = 0.03), while stress score was significantly improved at 1-2 months (SMD = -0.41; 95% CI: [-0.74 to -0.07]; P = 0.02).
CONCLUSION: ACT reduced anxiety, depression, and stress versus treatment-as-usual. Additionally, ACT reduced anxiety and stress scores at 1-2 months versus the control group. However, no improvement was observed in CD or UC activity. ACT was not superior to other active controls, such as CBT. Larger, longer follow-up periods and randomized trials are needed to confirm effects on psychological outcomes and disease activity.
