P482 The experiences of people with IBD and comorbid anxiety or depression and their views on an online intervention for people with long term conditions (COMPASS): A qualitative framework analysis
Harston, E.(1)*;
(1)King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom;
Background
IBD has high levels of comorbid mental health conditions, with anxiety and depression being more common in patients with IBD than the general population. Despite this, few studies have qualitatively explored the experience of IBD and comorbid anxiety and depression together, and little is known about how the population would experience a long-term condition (LTC) specific psychological intervention. An online, digital, transdiagnostic therapy for LTCs (COMPASS) has been trialled in a range of health conditions, and the current study aims to qualitatively evaluate the experience of COMPASS from the perspective of IBD patients.
Methods
n=22 adults with IBD and comorbid anxiety/depression that is felt to be related or part-related to their IBD who participated in the intervention arm of the COMPASS parallel-group randomised control trial were interviewed. The interviews covered both their experience of living with IBD and comorbid anxiety or depression, in addition to their experience of the COMPASS intervention. The data was analysed using framework analysis.
Results
'Embarrassment, shame and stigma' was found to be an overarching theme from the experience of adults living with IBD and comorbid anxiety or depression. This theme influenced the core themes of 'isolation', 'identity changes' and the 'perceived lack of control'. The experience of COMPASS was qualitatively reported as being beneficial, in addition to reducing scores on the PHQ-ADS from baseline (M=21.78 SD=9.20) to the end of the intervention (M=11.36, SD=6.05 at 12 weeks). Themes highlighted from the experience of COMPASS included a sense of 'connection and support', 'practical benefits of COMPASS' and 'the empowering process', in addition to highlighting areas of improvement. The themes from these two areas were found to compliment each other and were mapped together to illustrate the potential interaction.
Conclusion
This study highlighted the cyclical, interconnected nature of IBD and anxiety/depression, with participants noting bidirectional influence between their physical and mental health. Participants found the COMPASS intervention to be accessible for people with IBD and felt it addressed the need for psychological support within IBD care. Future research could tailor the COMPASS intervention to further suit the needs of the IBD population, focusing more on IBD-specific anxieties relating to incontinence and toilet access, hypervigilance around physical symptoms and fear of recurrence and progression, as well as doing more to address embarrassment, shame and stigma in this population.