COMPASS Programme for anxiety and low mood

What the researchers will look at

Crohn's and Colitis are both long-term conditions. Having any long-term condition makes it more likely that you will experience anxiety or depression (low mood).  About 1 in every 4 people living with Crohn’s and Colitis experience depression and about 1 in 3 experience anxiety. This is more common at certain times, such as at diagnosis or during a flare-up. However emotional support, such as talking therapies, can be difficult to access when it is most needed.

COMPASS is an online programme that has been developed to help people with one or more long-term conditions cope with anxiety and low mood. COMPASS is based on a treatment called cognitive behavioural therapy (CBT). The aim of CBT is to help you explore thoughts, feelings, and behaviours which may make low mood and anxiety worse, and based on this knowledge, develop helpful ways of managing low mood and anxiety. Using CBT, COMPASS focusses specifically on understanding how a medical long-term condition (LTC) contributes to depression and anxiety, and aspects of managing a long-term condition, such as coping with symptoms or uncertainty.

The researchers of this study have already shown in a randomised controlled trial that COMPASS reduces low mood and anxiety in a range of long term conditions. Now they want to maximise these effects by creating a version of the programme tailored specifically to Crohn’s and Colitis. As part of this, they will work together with people living with Crohn’s and Colitis to get feedback on and modify the current COMPASS programme to ensure it addresses particular challenges that people living with Crohn’s and Colitis may experience.

In the second part of this research, the researchers will explore how COMPASS-IBD could best be integrated into standard NHS care for people with Crohn’s and Colitis.  People attending a large London-based Gastroenterology service with Crohn’s and Colitis will be assessed for symptoms of low mood and anxiety. This will identify those who might benefit from using COMPASS. It will also identify people who may benefit from more intensive treatment with a clinical psychologist. People who are assessed as having mild to moderate depression or anxiety will be offered treatment with COMPASS-IBD. People who are assessed as having severe depression or anxiety will also be offered treatment with COMPASS-IBD whilst they are awaiting treatment with a clinical psychologist.

People using COMPASS will be asked to complete a questionnaire before they start treatment and when they finish. This will help the researchers see whether COMPASS-IBD had any effect on the participants’ low mood or anxiety, their symptoms and how they manage their condition. They will also look at whether using COMPASS-IBD means that fewer people feel they need more intensive treatment with a psychologist. How the service finds integrating regular assessments of depression and anxiety and COMPASS as a treatment as part of their routine care will also be assessed.

What could this mean for people with Crohn’s and Colitis?

Low mood and anxiety are common in people with Crohn’s and Colitis. People with low mood or anxiety often find it more difficult to manage their condition, but low mood and anxiety are not regularly assessed in people with Crohn’s and Colitis. Having low mood and anxiety alongside Crohn’s and Colitis can result in poorer medical outcomes. When they are identified, support is not always available. By identifying people with mild to moderate depression and anxiety early and providing easy access to a targeted therapy, it is hoped that we will be able to prevent symptoms getting worse and reduce the need for further treatment.

Who is leading this research: Dr Federica Picariello and Professor Rona Moss-Morris, King's College London
Our funding: £98,571
Duration: 18 months
Official title of application: Feasibility study to assess the implementation of routine mental health screening and guided web-based cognitive behavioural therapy tailored for treating anxiety and depression in Inflammatory Bowel Disease (IBD) in a large NHS gastroenterology service