Biopsychosoc Sci Med. 2025 Nov 21. doi: 10.1097/PSY.0000000000001457. Online ahead of print.
ABSTRACT
BACKGROUND: Inflammatory Bowel Disease (IBD) is commonly accompanied by psychological distress, which may worsen disease activity via gut-brain axis mechanisms. Psychological interventions including cognitive behavioural therapy (CBT) seem to reduce distress and inflammation in IBD. However, accessibility to psychological care remains limited. COMPASS-IBD, a digital CBT intervention tailored to IBD, aims to address these gaps.
OBJECTIVES: This nested exploratory, real-world study (NCT05330299) assessed the effectiveness of COMPASS-IBD in reducing inflammation, disease activity and healthcare use in IBD patients. Additionally, it examined relationships between changes in psychological distress and disease indicators.
METHODS: Adults with IBD experiencing psychological distress were recruited from a large gastroenterology service, and enrolled in COMPASS-IBD. Disease-related primary outcomes were faecal calprotectin (FCP) and C-reactive protein (CRP) and self-reported disease activity (SRDA). Secondary outcomes included other inflammatory biomarkers (neutrophils, monocytes, lymphocytes, white blood cells (WBC), ferritin), flare frequency, and healthcare usage. The Patient Health Questionnaire-Anxiety and Depression Scale (PHQ-ADS) measured distress. Mixed-effects models evaluated outcomes at baseline, 12-weeks, and 6-months.
RESULTS: Sixty-five participants were included. There were significant reductions in CRP (d range: -0.47- -0.53, P<0.01), but not FCP (d range: -0.38 to -0.44, P<0.10) or SRDA (d=-0.28, P=0.08). Significant improvements were observed in WBC and neutrophil counts (P<0.05), flare frequency (P<0.01) and psychological distress (P<0.001). Some types of healthcare usage were reduced (P<0.05). Associations between distress and primary outcomes were nonsignificant.
CONCLUSIONS: This pilot suggests COMPASS-IBD may reduce inflammation levels, healthcare use and psychological distress. However, analyses were underpowered. Larger randomized trials are needed to confirm findings, establish cost-effectiveness and explore underlying gut-brain mechanisms.
PMID:41427616 | DOI:10.1097/PSY.0000000000001457