Impact of anxiety, depression and online mindfulness on IBD patients' quality of life: a web-based cross-sectional survey and randomized pilot study.

BACKGROUND: Individuals with Inflammatory Bowel Disease (IBD) often suffer from psychological comorbidities, including symptoms of anxiety and depression, which contribute to a substantial impairment in quality of life (QOL). The potential benefits of online mindfulness interventions for IBD remain unexplored. OBJECTIVE: Study 1 (cross-sectional survey): To establish correlations between the severity of depression and anxiety and the QOL in IBD patients. Study 2 (pilot study): To evaluate the feasibility and preliminary effects of a mobile-delivered mindfulness intervention on psychological symptoms and QOL/sleep quality. METHODS: Study 1: Anxiety, depression and QOL were measured using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Short Health Scale (SHS) respectively. They were assessed in 484 IBD patients. Regression analyses determined associations. Study 2: A randomized parallel design tested the Online MINdfulness-based stress reduction with Daily EXercise (MINDEX) program vs an active control (IBD education video) over 2 months. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI). Feasibility was assessed via retention (30/36 intervention vs. 22/36 control completers) and all completion rates (25%); Preliminary effects via GAD-7/PHQ-9/SHS/PSQI changes. RESULTS: Study 1: More than 80% of the patients had severe anxiety or depression. The study revealed a significant association between increased GAD-7 scores and SHS scores, with an R2 of 0.43 and coefficient of 12.6 (95% CI 9.4–15.7) for UC (Ulcerative Colitis) and R2 of 0.27 with a coefficient of 10.4 (95% CI 8.8–12.1) for CD (Crohn’s Disease). Similarly, higher PHQ-9 scores correlated significantly with higher SHS scores, with an R2 of 0.37 and a coefficient of 9.2 (95% CI 6.5–11.8) for UC, and an R2 of 0.22 with a coefficient of 7.2 (95% CI 5.9–8.6) for CD. Study 2: 30 MINDEX patients completed the intervention, and 22 control patients completed the control program. At two-month follow-up, no statistically significant differences were observed in GAD-7, PHQ-9, SHS or PSAI scores between the MINDEX group and the control group (0.052 < P < 0.908). CONCLUSIONS: Study 1: Our findings indicate strong associations between psychological symptoms and QOL in IBD, while causal relationships require Longitudinal investigation. Study 2: While feasibility to implement this pilot trial found no significant short-term benefits of MINDEX on anxiety, depression, QOL, or PSQI over the 2-month study period. Larger trials with longer follow-up are needed to evaluate efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT04939948, Clinical Trial Registry June 17, 2021.