Motivation for Psychotherapy in Patients With Functional Gastrointestinal Disorders

Background: The motivation of patients with functional gastrointestinal disorders to accept psychotherapy (PT) as a treatment option is not known. Objective: The authors investigated motivation for patients' refusal to participate and dropout from PT/medical management programs. Method: Consecutive patients with symptoms suggestive of functional bowel disorders, seen at the outpatient clinic of a tertiary gastrointestinal (GI) center were evaluated for their motivation to undergo PT. Data from 85 patients were evaluated in two phases: In Phase 1, patients were asked about willingness to participate in PT if it were offered; in Phase 2, patients were offered PT. In both samples, PT motivation was also measured by standardized psychometric scales. Results: Age, gender, social status, and clinical symptom severity did not predict willingness to participate in or accept PT. Motivation was higher when patients were directly recruited in a GI setting than a psychosomatic outpatient unit. Quantitative assessment of PT motivation also did not correlate with declared PT motivation or participation. Assessment of interpersonal problems were among the few variables that were related to participation in PT. Conclusion: Motivation for PT in patients with functional gastrointestinal disorders is low and is not determined by clinical, but, rather, by interpersonal problems that may exist beyond and independent of GI symptoms. (Psychosomatics 2010; 51: 225-229)