School of Psychology, Deakin University, Geelong, Victoria, Australia.
Department of Medicine, Christchurch School of Medicine and Health Sciences, Univeresity of Otago, Christchurch, New Zealand.
Inflamm Bowel Dis. 2024 Jun 3;30(6):911-921. doi: 10.1093/ibd/izad122.
The bidirectional relationship between inflammatory bowel disease (IBD) flare-ups and depression/anxiety symptoms has prompted investigations into psychotherapy to improve health-related quality of life (HRQoL) by targeting depression and anxiety. Acceptance commitment therapy (ACT) is effective in improving symptoms of depression and anxiety in people with chronic diseases, yet minimal research has examined ACT's effectiveness for IBD. This study examines the feasibility, acceptability, and preliminary efficacy of the ACTforIBD program, an online program codesigned with consumers to deliver ACT to those with IBD.
Adults with IBD and symptoms of mild-moderate distress were randomized to ACTforIBD or an active control (psychoeducation) condition. Participants completed 8 weekly, 1-hour sessions, 4 of which were therapist facilitated. Feasibility was based on recruitment and retention and acceptability was derived from postprogram satisfaction measures. Preliminary efficacy was determined by group differences in rate of change in study outcomes from baseline to postprogram.
Of 62 participants (89% women, 11% men; mean age 33 years), 55 completed the program (ACTforIBD: n = 26 [83.9%]; active control: n = 29 [93.5%]). Adherence and acceptability were high in the ACTforIBD group, with 80% of participants completing all self-directed modules and 78% of participants expressing satisfaction with the program. Significant and marginally significant group × time interactions were found for anxiety symptoms (b = -1.89; 95% confidence interval, -3.38 to -0.42) and psychological HRQoL (b = -0.04; 95% confidence interval, -0.07 to 0.01), showing decreased anxiety and increased psychological HRQoL in the intervention group.
ACTforIBD is feasible, acceptable, and improved anxiety symptoms, and psychological HRQoL. This highlights the need for a full-scale randomized controlled trial to further examine the program's efficacy.
炎症性肠病（IBD）发作与抑郁/焦虑症状之间的双向关系促使人们研究心理治疗，通过针对抑郁和焦虑来改善与健康相关的生活质量（HRQoL）。接受承诺疗法（ACT）在改善慢性疾病患者的抑郁和焦虑症状方面非常有效，但很少有研究检查 ACT 对 IBD 的有效性。本研究检查了 ACTforIBD 计划的可行性、可接受性和初步疗效，这是一个与消费者共同设计的在线计划，旨在向 IBD 患者提供 ACT。
有 IBD 和轻度中度困扰症状的成年人被随机分配到 ACTforIBD 或积极对照（心理教育）条件。参与者完成了 8 周、1 小时的课程，其中 4 周由治疗师进行指导。可行性基于招募和保留情况，可接受性则来自于方案后满意度的衡量。初步疗效是通过从基线到方案后的研究结果变化率的组间差异来确定的。
在 62 名参与者（89%为女性，11%为男性；平均年龄 33 岁）中，有 55 名完成了该方案（ACTforIBD：n=26 [83.9%]；积极对照组：n=29 [93.5%]）。ACTforIBD 组的依从性和可接受性很高，80%的参与者完成了所有的自我指导模块，78%的参与者对该方案表示满意。焦虑症状（b=-1.89；95%置信区间，-3.38 至 -0.42）和心理 HRQoL（b=0.04；95%置信区间，-0.07 至 0.01）方面存在显著和边缘显著的组间×时间交互作用，表明干预组的焦虑症状减轻，心理 HRQoL 提高。
ACTforIBD 是可行的、可接受的，并且可以改善焦虑症状和心理 HRQoL。这凸显了进行全面的随机对照试验以进一步研究该方案疗效的必要性。
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