This study will use both questionnaires and semi-structured interviews to understand how IBD
patients have been impacted psychologically by the CoViD-19 pandemic and identify various
factors that may affect the extent to which patients have been impacted. This study will also
incorporate longitudinal questionnaire follow-up of the same patients, in order to try and
understand the long-term impact of the pandemic, and to assess changes in psychological
impact accompanying changes in the national situation.

Patients identified from those attending the IBD clinic will be contacted. As part of the
NHSE and local Trust CoViD response, lists of all patients attending the IBD clinics and
those deemed to be at high risk of infection have been created.

This study aims to recruit 100 patients from the high-risk group and 100 patients from the
non-high-risk group. Basedon an approximately 33% response rate, we have therefore elected to
identify 300 patients from the high-risk groups and 300 from non-high-risk groups. These 600
patients in total will be contacted via the post, and mailed:

1. An explanatory cover letter, with instructions on how to participate in the study

2. Participant information sheet (PIS)

3. Consent form

4. Questionnaires

5. A stamped and addressed return envelope

Completion of questionnaire and return to site will constitute as consent for this data to be
used. Postal recruitment is being used to maximise the chances of reaching those who may have
been most affected by isolation and may have limited access to the internet. The consent form
will apply to the optional interview component.

The PIS will include information signposting patients to help and support should they have
difficulties or concerns relating to the study or the psychological impact of their condition
or current situation.

Record of who has been contacted to participate will be kept on NHS computers, with patient
hospital numbers corresponding to anonymous and non-identifiable study identification
numbers. Keeping record will permit there to be available data regarding the questionnaire
return rate. This will also potentially allow for demographic details to be retrieved from
patient records regarding those who did not return responses, to facilitate both assessment
of differences between responders and non-responders and provide information about those who
elected not to participate.

In addition, a sub-set of 32 young people will be contacted and recruited. This sub-set have
already undertaken the assessment of psychological morbidity, outlined below, during a
previous, pre-CoViD outbreak study (STH20960 IRAS: 269881) and have agreed to further
follow-up. These patients will also be contacted via the post to complete the same set of
questionnaires and therefore provide follow-up, to assess whether measures of psychological
morbidity changed following the onset of the CoViD crisis.

Patients will be asked to complete the following questionnaires:

1. IBD symptoms: IBD control questionnaire

2. Experience during the CoViD periods of isolation

3. Impact of event scale (iES-15 questionnaire)

4. Depression Anxiety Stress Scale-21 (DASS-21)

Background information, as listed below, will be collected in order to try and identify
demographic and disease related details which may affect the level of psychological impact
for IBD patients:

1. Age

2. Ethnicity

3. Postcode (used to calculate indices of deprivation scores, using the Indices of Multiple
Deprivation [IMD] tool)

4. Disease type

5. Medication

6. BSG risk group

The same patients will be contacted and asked to complete the questionnaires again after 6
and 12 months to assess changes in psychological impact and relationship to societal
requirements for isolation.

Semi structured interviews will be undertaken with approximately 20 participants. More may be
undertaken until saturation point is reached.

Semi-structured interviews will be undertaken to provide further detail about the experience
of isolation during the pandemic to explore issues to include factors which improve or worsen
the experience of isolation including:

- The effect of the isolation itself

- The effect of variations in information provision

- Concern about infection risk and its variation during the period of "lock-down"

- Delays to presentation with flare symptoms