Online assisted psychological therapy for targeted populations with inflammatory bowel disease.

Introduction: Inflammatory bowel disease (IBD) is a chronic condition affecting over
300,000 people in the UK. Despite a high level of comorbid mental disorders, most
patients do not receive psychological help. As a result of scarce healthcare resources in
IBD, technology is increasingly being recognised as a useful tool to manage anxiety and
depression associated with IBD. However, there is no online psychotherapy
programme for patients with IBD and comorbid anxiety and/or depression available in
the UK.
Aim: The aim of this thesis was to develop a prototype online psychological
intervention for patients with IBD and comorbid anxiety and/or depression.
Methods: The development of the prototype followed the Medical Research Council
(MRC) framework for complex interventions (the development phase). Firstly,
theoretical evidence on the effectiveness of online psychological therapy in
gastrointestinal diseases was gathered in a systematic review. Secondly, a qualitative
study investigated patients' with IBD and comorbid anxiety and/or depression and
their service providers' views about lived experiences with IBD and about an online
psychological intervention. Finally, the recommendation for the online psychological
intervention for this population was provided.
Results: The evidence on the usefulness of online psychological interventions in
gastroenterology, and IBD specifically, is scarce. There is a need for more robust trials
of psychotherapy in IBD, particularly in patients with IBD and anxiety and/or
depression. Patients had positive attitude towards online psychological intervention,
while health professionals were unsure about patients' participation in the
intervention. Based on the theoretical evidence and the qualitative study findings the
recommendations for the future interventions were developed.
Conclusions: This PhD project demonstrated the need for an online psychological
intervention for patients with IBD and comorbid anxiety and/or depression. The
intervention based on the prototype could be tested in a future trial. The productive
collaborations between patients, stakeholders and researchers in co-designing of an
online psychological intervention are essential during the development, evaluation and
implementation of the intervention.