INTRODUCTION The bidirectional relationship between disease activity and mental health in inflammatory bowel disease (IBD) has prompted investigations into the efficacy of psychotherapeutic interventions such as acceptance and commitment therapy (ACT) on biopsychosocial outcomes. We aimed to examine the efficacy of an ACT program (intervention) in comparison with a cognitive behavioral therapy-informed psychoeducation program (active control) for individuals with IBD and coexistent psychological distress. Both programs were delivered online through a hybrid format (i.e., therapist-led and participant-led sessions). METHODS A total of 120 adults with IBD were randomized to either the intervention (N = 61) or active control groups (N = 59). Efficacy was determined using linear mixed models for group differences, in rate of changes in study outcomes, between baseline, postintervention, and 3-month follow-up. RESULTS The primary outcome health-related quality of life significantly improved in the intervention group when compared with the active control group, with a significantly different rate of change observed from baseline to postintervention ( t [190] = 2.15, P = 0.033) in favor of the intervention group with a medium effect size (β = 0.41, mean difference = 0.07, 95% confidence interval 0.01-0.12, P = 0.014). Similarly, the secondary outcome Crohn's disease activity significantly reduced in the intervention group when compared with the active control group, with a significantly different rate of change observed from baseline to 3-month follow-up ( t [90] = -2.40, P = 0.018) in favor of the intervention group with a large effect size (β = -0.77, mean difference = -9.43, 95% confidence interval -13.72 to -5.13, P < 0.001) ( P = 0.014). Furthermore, when observing the rate of change in outcomes over time for the groups separately, anxiety symptoms and pain significantly improved in the intervention group only, and conversely, ulcerative colitis activity and stress symptoms significantly improved in the active control group only. All other outcomes (N = 14) significantly improved over time in both groups including IBD activity, gastrointestinal unhelpful thinking patterns, visceral anxiety, fatigue interference, fatigue severity, fatigue frequency, psychological inflexibility, self-efficacy, resilience, current health status, depression symptoms, IBD control, and pain catastrophizing; however, these changes were not significantly different between the groups. DISCUSSION Both programs were of benefit to people with IBD and distress. However, ACT offers a significant added benefit for health-related quality of life and self-reported Crohn's disease activity and may be a useful adjuvant therapy in integrated IBD care.

中文翻译：

---

患有炎症性肠病和困扰的成年人的接受和承诺疗法：一项随机对照试验。


引言炎症性肠病（IBD）疾病活动性与心理健康之间的双向关系促使人们研究心理治疗干预措施（例如接受和承诺疗法（ACT））对生物心理社会结果的功效。我们的目的是比较 ACT 计划（干预）与认知行为治疗指导的心理教育计划（主动控制）对 IBD 和共存心理困扰患者的疗效。这两个项目均通过混合形式在线提供（即治疗师主导和参与者主导的课程）。方法 总共 120 名 IBD 成人被随机分为干预组 (N = 61) 或积极对照组 (N = 59)。使用线性混合模型确定基线、干预后和 3 个月随访之间的组间差异、研究结果的变化率来确定疗效。结果 与主动对照组相比，干预组的主要结局健康相关生活质量显着改善，从基线到干预后观察到的变化率显着不同（t [190] = 2.15，P = 0.033）中等效应大小的干预组（β = 0.41，平均差 = 0.07，95% 置信区间 0.01-0.12，P = 0.014）。同样，与主动对照组相比，干预组的次要结果克罗恩病活动性显着降低，从基线到 3 个月随访观察到的变化率显着不同（ t [90] = -2.40，P = 0.018）支持具有较大效应量的干预组（β = -0.77，平均差 = -9.43，95% 置信区间 -13.72 至 -5.13，P < 0.001）（ P = 0.014）。 此外，当分别观察各组结果随时间的变化率时，仅干预组的焦虑症状和疼痛显着改善，相反，仅主动对照组的溃疡性结肠炎活动和应激症状显着改善。随着时间的推移，两组的所有其他结果 (N = 14) 均显着改善，包括 IBD 活动、胃肠道无益思维模式、内脏焦虑、疲劳干扰、疲劳严重程度、疲劳频率、心理僵化、自我效能、复原力、当前健康状况、抑郁症状、IBD 控制和疼痛灾难化；然而，这些变化在各组之间没有显着差异。讨论 这两个项目都对 IBD 和痛苦患者有益。然而，ACT 为健康相关的生活质量和自我报告的克罗恩病活动提供了显着的额外益处，并且可能是 IBD 综合护理中有用的辅助疗法。