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Internet-delivered Psychological Treatment of Functional Gastrointestinal Disorders

4 giugno 2026 aggiornato da: University of Aarhus

Internet-delivered Psychological Treatment of Functional Gastrointestinal Disorders - A Danish Feasibility Study

Brief Summary

Functional gastrointestinal disorders (FGID), including irritable bowel syndrome (IBS), are common conditions characterized by recurrent gastrointestinal symptoms that cannot be fully explained by structural disease. FGID are associated with reduced quality of life, functional impairment, psychiatric comorbidity, and high healthcare utilization. Psychological interventions, particularly cognitive behavioral therapy (CBT), have demonstrated beneficial effects in FGID, but access to specialized treatment remains limited.

This study aims to evaluate the feasibility, acceptability, and potential clinical effects of a Danish exposure-based internet-delivered cognitive behavioral therapy (iCBT) program for adults with FGID. The intervention has been translated and culturally adapted from a Swedish program with previously documented efficacy.

In this single-arm feasibility study, 30 adults with FGID will complete a 10-week therapist-supported iCBT program consisting of psychoeducation, symptom monitoring, identification of avoidance behaviors, exposure exercises, and relapse prevention strategies. Participants will receive asynchronous weekly written support from trained CBT therapists.

Feasibility outcomes include treatment adherence and completion, participant satisfaction, treatment credibility, working alliance, adverse effects, and acceptability of the internet platform. Clinical outcomes include gastrointestinal symptom severity and quality of life, alongside measures of illness perceptions, illness worry, emotional distress, behavioral responses, functional symptoms, and spontaneous cognition during rest. Assessments will be conducted at baseline, post-treatment, and 3-month follow-up.

The study is conducted in Denmark as part of The Danish FGID Treatment Study through collaboration between Aarhus University Hospital, Regional Hospital Silkeborg, Aarhus University, and Karolinska Institute, Sweden. The findings will inform the future implementation and evaluation of internet-delivered psychological treatment for Danish patients with FGID.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

OBJECTIVE: To test the feasibility of an exposure-based internet-based cognitive behavioral therapy (ICBT) treatment not previously evaluated in Denmark for adults with FGID in a Danish clinical context.

DESIGN: This is a feasibility study testing a of an exposure-based I-CBT treatment for FGID not previously evaluated in Denmark.

PARTICIPANTS: 30 adults with functional gastrointestinal disorder

PROJECT GROUP: Lisbeth Frostholm (Principal Investigator); Charlotte Ulrikka Rask (Principal Investigator); Karen Hansen Kallesøe; Heidi Frølund Pedersen; Lotte Fynne; Lise Gormsen (FL); Laura Krogsgaard (FL). Brjann Ljötsson, Erik Hedman

The Danish FGID Treatment Study is a joint cooperation between Regional Hospital Silkeborg, Department of Functional Disorders (FL), Aarhus University Hospital, the Research Unit at the Department of Child and Adolescent Psychiatry (BUA), Aarhus University Hospital, the Department of Clinical Medicine (CM), Aarhus University, and the Department of Clinical Neuroscience (CNS) at the Karolinska Institute in Stockholm, Sweden.

The trial will be conducted by the research group at the Dept. of Functional Disorders (www.functionaldisorders.dk), based at Aarhus University Hospital, Denmark. The clinic was established in 1999 and offers assessment and specialized treatment to patients with severe FSD. Patients are recruited from Regional Hospital Silkeborg

MAIN HYPOTHESIS: The feasibility of the I-CBT program will be assessed positively by the patients. At least 70% of included patients will complete the treatment. Furthermore, the I-CBT program will reduce symptoms of FGID and increase quality of life in patients with FGID.

INTERVENTION: The i-CBT program build on exposure based therapy and consists of 5 modules and takes 10 weeks to complete. The participants will be expected to use approximately 4 hours per week on the treatment. Asynchronous written support will be provided by a therapist on a weekly basis.

MEASUREMENTS: Self-reported measures will be administered to patients at several timepoints during the course of treatment, including before the start of the program (baseline, 0 weeks), after treatment (10 weeks), at the 3-month follow-up (22 weeks, primary endpoint), Beyond this, patients will receive a short daily questionnaire 5 times a day for 2 week (week 2 and week 8 into treatment)

Furthermore, therapist will evaluate patients' progress post-treatment (after 10 weeks). Therapists will record number and time usage of telephone/video consultations throughout the treatment. The treatment program will continually log the participants' data during the treatment period.

For a detailed list of the measures and measurement time points included, see the section "Outcome measures".

ANALYSIS: Data will be presented and analyzed according to current guidelines for feasibility studies

ETHICAL CONSIDERATIONS: The fesibility study presents low risks (side-effects and/or disadvantages) for the patients who may end their participation at any time point and can get into contact with a physician if their physical/mental health state deteriorates significantly. After patients have reached their final end-point, at the 3-month follow-up, they will be invited to a follow-up consultation with a medical doctor where their health/mental status will be assessed, and the need for further treatment discussed.

A study protocol has been approved by the Research Ethics Board of Aarhus University Hospital for approval (case.nr. 1-10-72-127-25). A pre-registration of the study has been submitted to ClinicalTrials.gov before the onset of the feasibility study. Data will be handled according to Danish law on the Data Protection Act and the Data Protection Regulation, and have been approved by the Danish Data Protection Agency (case.nr. 772917).

Tipo di studio

Interventistico

Iscrizione (Stimato)

30

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: Heidi F Pedersen, Ph.D.
  • Numero di telefono: 0045-78464310
  • Email: heidpd@rm.dk

Backup dei contatti dello studio

  • Nome: Lise Gormsen, Ph.D.
  • Numero di telefono: 0045-78464310
  • Email: lisegorm@rm.dk

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  1. Age ≥ 18.
  2. A primary diagnosis of functional disorders, gastrointestinal, specifically irritable bowel syndrome operationalized by ROME IV (DR58)
  3. Normal recommended routine medical investigations: growth, blood samples including TSH, total IgA, IgA-tissue transglutaminase, complete blood count, erythrocyte sedimentation rate and C-reactive protein analysis, liver enzymes and fecal calprotectin.
  4. Refractory gastrointestinal functional symptoms despite medical treatment (in accordance with guidelines)
  5. Stable dosage of FGID-related medication such as laxatives, Imodium or pain-modulating psychopharmacological medication during the past month.
  6. Living in Denmark.
  7. Access to a computer or tablet with an internet connection.

    -

Exclusion Criteria:

  1. - Another disease that explains the symptoms.
  2. Chronic inflammatory bowel disease (e.g., Crohns, colitis ulcerosa).
  3. Lactose intolerance, celiac disease, and food allergies, in accordance with guidelines.
  4. Severe psychiatric problems (e.g., suicidal ideation, depression).
  5. Insufficient language or computer skills.
  6. Addiction to alcohol, drugs or medicine.
  7. Treatment with opioids or other addictive drugs such as benzodiazepines
  8. Lactose-/gluten-intolerance where the diet has not been adjusted accordingly.
  9. Severe cognitive or intellectual dysfunction or diagnosed autism spectrum disorder, which prevent the participant from interaction with the program
  10. Ongoing psychological treatment.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Internet-delivered psychological treatment for FGID
The i-CBT program consists of 5 modules and takes 10 weeks to complete.
Experimental : Internet-delivered psychological treatment for FGID The i-CBT program consists of 5 modules and takes 10 weeks to complete. The participants will be expected to use approximately 4 hours per week on the treatment. Asynchronous written support will be provided by a therapist on a weekly basis. The therapists are experienced in CBT treatment and will receive regular supervision by the Swedish collaborators. The treatment program consists of the following. 1) Thorough information regarding FGID provided as text. 2) Introduction to basic treatment principles of CBT provided as text. 3) Exercises to help the patients become aware of their FGID symptoms and FGID-related thoughts in daily life. 4) Exercises to help the patients discover what they have been avoiding due to their symptoms (e.g. specific foods, situations or activities). 5) Exposure exercises to previously avoided foods, situations or activities.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Gastrointestinal Symptom Rating Scale - Irritable Bowel Syndrome (GSRSIBS; Wiklund et al. 2003)
Lasso di tempo: Distributed at baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
20 item measure of gastrointestinal symptoms measured at a 0-6 scale
Distributed at baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Irritable Bowel Syndrome Quality of Life (IBS-QOL; Patrick et al., 1998)
Lasso di tempo: Measured at baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
34 items on quality of life measured a a 0-4 scale
Measured at baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
ROME IV
Lasso di tempo: Baseline and 3 month follow-up
Measures gastrointestinal symptoms, 5 items at a 0-8 scale
Baseline and 3 month follow-up
NIAS: Nine Item Avoidant/Restrictive Food Intake disorder screen
Lasso di tempo: At screening (before inclusion) and 3 month follow-up
Measures food intake, 9 items at a 0-5 scale
At screening (before inclusion) and 3 month follow-up
Bodily Distress Syndrome Checklist (BDS Checklist; Budtz-Lilly et al., 2015)
Lasso di tempo: Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 months follow-up
25 items on bodily symptoms from 4 organ systems, measured on a 0-4 scale
Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 months follow-up
Illness Perception Questionnaire (IPQ; Broadbent et al., 2006, 2015)
Lasso di tempo: Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up

21 items on illness perception measured of which 9 are measured at a 0-10 scale

1 item at a categorical scale consisting of 4 categories

1 open-ended questions on the cause of symptoms (possible to write up to 3 different causes) 10 items measured at a 0-3 scale

Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Whiteley index (Conradt et al., 2006; Fink et al., 1999)
Lasso di tempo: Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
8 items measured at a 0-4 scale
Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Symptom Check List - Anxiety and Depression subscales (SCL-ANX &´SCL-DEP; Christensen et al., 2005; Derogatis, 1983)
Lasso di tempo: Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Symptoms of anxiety and depression, 13 items measured at a 0-4 scale
Screening, baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Questionnaire on healthcare consumption and productivity losses for patients with a psychiatric disorder (TiC-P; Bouwmans et al., 2013)
Lasso di tempo: Baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up

Working hours and sick leave, 10 items of which 6 items are mesured as days 3 items as dichotomized (yes/no)

1 item measured at a 0-10 scale

Baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Amsterdam Resting State Questionnaire (ARSQ; Diaz et al., 2013, 2014)
Lasso di tempo: Baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up

44 items of which 36 items are measured at a 0-4 scale 6 measured as dichotomized (yes/no)

1 item on a 1-4 scale

1 open space to write a comment

Baseline, end of treatment (i.e. after 10 weeks of treatment), and 3 month follow-up
Patient global impression of change (PGIC; Guy, 1976; Perrot & Lantéri- Minet, 2019)
Lasso di tempo: end of treatment (i.e. after 10 weeks of treatment),
Self-perceived change, 1 items measured at 5 point scale (0-4)
end of treatment (i.e. after 10 weeks of treatment),
Mind-wandering in daily life (Kane et al. 2007)
Lasso di tempo: 5 times a day over 2 seperate weeks (week 2 and 8)
Mind-wandering measured 5 times a day over 2 seperate weeks with 5 items measured at a 0-4 scale
5 times a day over 2 seperate weeks (week 2 and 8)

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Expectation for counseling success (ECS; Kim et al., 2005)
Lasso di tempo: Baseline and end of treatment (i.e. after 10 weeks of treatment),
6 items on a 0-10 scale
Baseline and end of treatment (i.e. after 10 weeks of treatment),
Evaluation of the treatment
Lasso di tempo: end of treatment (i.e. after 10 weeks of treatment),
5 items measured at 0-3 and 3 open-ended questions
end of treatment (i.e. after 10 weeks of treatment),
Evaluation of assessment at the doctor
Lasso di tempo: Baseline
3 items measured at 0-3 and 3 open-ended questions
Baseline
Working Alliance Inventory - Short Form (WAI-SF; Tracey & Kokotovic, 1989)
Lasso di tempo: end of treatment (i.e. after 10 weeks of treatment),
12 items measured at a 0-6 scale
end of treatment (i.e. after 10 weeks of treatment),
Inventory for the balanced assessment of Negative Effects of Psychotherapy (INEP; Ladwig, Rief & Nestoriuc, 2014)
Lasso di tempo: end of treatment (i.e. after 10 weeks of treatment),
41 items on potential side effects: 16 items measured at 0-3 13 items rating whether a side effect was caused by the treatment (worse, not relevant, better) 2 open ended questions
end of treatment (i.e. after 10 weeks of treatment),
LEVA
Lasso di tempo: end of treatment (i.e. after 10 weeks of treatment),
Evaluation of the internet program, 6 items at a 0-5 scale
end of treatment (i.e. after 10 weeks of treatment),

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Lisbeth Frostholm, Professor, Department for Functional Disorders, Aarhus University Hospital/Aarhus University

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

30 maggio 2026

Completamento primario (Stimato)

1 settembre 2027

Completamento dello studio (Stimato)

20 dicembre 2027

Date di iscrizione allo studio

Primo inviato

13 maggio 2026

Primo inviato che soddisfa i criteri di controllo qualità

4 giugno 2026

Primo Inserito (Effettivo)

9 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

9 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

4 giugno 2026

Ultimo verificato

1 maggio 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • FGID pilot study
  • ID: 147092 (Altro numero di sovvenzione/finanziamento: Trygfonden)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Descrizione del piano IPD

This is a pilot study, and we have not yet decided on procedures of sharing data

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .