The role of mindfulness in promoting wellbeing in patients with Crohn’s disease:

INTERVENTION: An eight week training in Mindfulness Based Stress Reduction consisting of 2.5 hours of instruction per week and 45 minutes per day of home practice. The course will utilize the materials from palousemindfulness.com (permission has been sought and received from the site owner), which include video and written materials. Mindfulness practices include mindful eating, body scans, focused breathing and gentle yoga poses. These are conducted during the sessions and in home practice tasks. The palousemindfulness course is designed to be self‐directed; however in this case the participants will meet as a group with a university student (doctoral student in clinical psychology) acting as facilitator. Maximum group numbers will be 10 per group. The group will be conducted in a meeting room at the rooms of the gastroenterologist (Dr Lauren Beswick) associated with the study. Each week participants will be given homework sheets to record their home practice; these will be collected and the times recorded as part of the data collection. The intervention is in addition to the standard care each patient will receive as part of their ongoing treatment with the gastroenterologist. CONDITION: Crohn's disease;Depression;Stress; ; Crohn's disease ; Depression ; Stress Inflammatory and Immune System ‐ Other inflammatory or immune system disorders Mental Health ‐ Depression PRIMARY OUTCOME: depression symptoms as determined by measurements on the Depression Anxiety and Stress Scale (Lovibond & Lovibond 1995)[Immediate post‐intervention and six=month follow up] SECONDARY OUTCOME: Homeostatically Protected Mood variability. This will be tested through a series of statistical analyses to participants answers to questions, how happy/content/alert they feel during a tw0‐week ecological momentary assessment period. The statistical analyses will include within‐person standard deviation, mean successive square differences and multi‐level‐modelling. [immediately post intervention and at six month follow up] Inflammation levels through levels of C‐reactive protein. These will be accessed through blood test results. Blood samples will be collected by the patient’s gastroenterologist as part of usual care. [immediately post‐intervention and at six month follow up] stress symptoms as determined by measurements on the Depression Anxiety and Stress Scale (Lovibond & Lovibond 1995)[immediately following intervention and at 6 month follow up] INCLUSION CRITERIA: 1) A clinically established diagnosis of Crohn’s disease (per usual clinical practice in a tertiary care centre) 2) Sufficient knowledge of English to understand the study instructions, answer the questionnaires and participate in the Mindfulness Based Stress Reduction group (MBSR). Note; as this is an exploratory study and involves a group intervention, it will not be possible to conduct the MBSR intervention in any language other than English. 3) 18 years of age or older 4) Competence to consent 5) Access to the internet by a smart phone and the willingness to download the Instant Survey app. 6) A willingness to commit to 2.5 hours of MBSR at the identified times for a period of 8 consecutive or near‐consecutive weeks, and engage with the homework sheets in the intervening period. 7) Scores of depression at mild or moderate levels of the DASS scale