title: Effectiveness of disease-specific cognitive-behavioural therapy on depression, anxiety, quality of life and the clinical course of disease in adolescents with inflammatory bowel disease: study protocol of a multicentre randomised controlled trial (HAPPY-IBD).
abstract: BACKGROUND
  Adolescents with inflammatory bowel disease (IBD) show a higher prevalence of depression and anxiety, compared to youth with other chronic diseases. The inflammation-depression hypothesis might explain this association, and implies that treating depression can decrease intestinal inflammation and improve disease course. The present multicentre randomised controlled trial aims to test the effectiveness of an IBD-specific cognitive-behavioural therapy (CBT) protocol in reducing symptoms of subclinical depression and anxiety, while improving quality of life and disease course in adolescents with IBD.
  
  
  METHODS
  Adolescents with IBD (10-20 years) from 7 hospitals undergo screening (online questionnaires) for symptoms of depression and anxiety. Those with elevated scores of depression (Child Depression Inventory (CDI) ≥13 or Beck Depression Inventory (BDI) II ≥14) and/or anxiety (Screen for Child Anxiety Related Disorders: boys ≥26, girls ≥30) receive a psychiatric interview. Patients meeting criteria for depressive/anxiety disorders are referred for psychotherapy outside the trial. Patients with elevated (subclinical) symptoms are randomly assigned to medical care-as-usual (CAU; n=50) or CAU plus IBD-specific CBT (n=50).
  
  
  RESULTS
  (1) reduction in depressive and/or anxiety symptoms after 3 months and (2) sustained remission for 12 months.
  
  
  RESULTS
  quality of life, psychosocial functioning, treatment adherence. In addition, we will assess inflammatory cytokines in peripheral blood mononuclear cells and whole blood RNA expression profiles. For analysis, multilevel linear models and generalised estimating equations will be used.
  
  
  BACKGROUND
  The Medical Ethics Committee of the Erasmus MC approved this study. If we prove that this CBT improves emotional well-being as well as disease course, implementation is recommended.
  
  
  BACKGROUND
  NCT02265588.
authors.affiliation: Department of Pediatric Gastroenterology , Erasmus MC-Sophia Children's Hospital , Rotterdam , The Netherlands.
authors.forename: Gertrude
authors.initials: G
authors.lastname: van den Brink
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology , Erasmus MC-Sophia Children's Hospital , Rotterdam , The Netherlands.
authors.forename: Luuk
authors.initials: L
authors.lastname: Stapersma
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology , Erasmus MC-Sophia Children's Hospital , Rotterdam , The Netherlands.
authors.forename: Hanan
authors.initials: H
authors.lastname: El Marroun
authors.affiliation: Department of Midwifery Science , AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.
authors.forename: Jens
authors.initials: J
authors.lastname: Henrichs
authors.affiliation: Department of Psychiatry , University of Pittsburgh , Pittsburgh, Pennsylvania , USA.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Szigethy
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychology , Erasmus MC-Sophia Children's Hospital , Rotterdam , The Netherlands.
authors.forename: Elisabeth Mwj
authors.initials: EM
authors.lastname: Utens
authors.affiliation: Department of Pediatric Gastroenterology , Erasmus MC-Sophia Children's Hospital , Rotterdam , The Netherlands.
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Escher
keywords: CROHN'S DISEASE; INFLAMMATORY BOWEL DISEASE; PSYCHOLOGICAL STRESS; PSYCHOTHERAPY; ULCERATIVE COLITIS