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P308 The need for psychological and psychotherapeutic interventions in Austrian patients with inflammatory bowel disease

M. Kutschera1, T. Waldhör2, H.P. Gröchenig3, T. Haas4, H. Wenzl5, P. Steiner6, R. Koch7, T. Feichtenschlager8, G. Eckhardt9, A. Mayer10, A. Kirchgatterer11, O. Ludwiczek12, R. Platzer13, P. Papay14, J. Gartner15, H. Fuchssteiner16, P.G. Peters17, G. Reicht18, G. Moser1, C. Dejaco1, C. Primas1, G. Novacek1, W. Miehsler19, Austrian IBD Study Group (ATISG)

1Medical University of Vienna, Department of Gastroenterology and Hepatology, Vienna, Austria, 2Medical University of Vienna, Department of Epidemiology, Vienna, Austria, 3Hospital Brothers of St. John of God St. Veit an der Glan, Department of Internal Medicine, St. Veit an der Glan, Austria, 4Darm Praxis Salzburg, Darm Praxis Salzburg, Salzburg, Austria, 5Medical University of Graz, Department of Gastroenterology and Hepatology, Graz, Austria, 6Hospital Wels-Grieskirchen, Department of Internal Medicine I, Wels, Austria, 7Medical University of Innsbruck, Department of Internal Medicine I, Innsbruck, Austria, 8Hospital Rudolfstiftung, Department of Internal Medicine IV, Vienna, Austria, 9Hospital Oberpullendorf, Department of Internal Medicine, Oberpullendorf, Austria, 10Universitätsklinikum St. Pölten, Department of Internal Medicine II, St. Pölten, Austria, 11Hospital Wels-Grieskirchen, Department of Internal Medicine V, Grieskirchen, Austria, 12Hospital Hall in Tirol, Department of Internal Medicine, Hall in Tirol, Austria, 13Hospital Wiener Neustadt, Department of Internal Medicine I, Wiener Neustadt, Austria, 14Franziskus Hospital, Department of Internal Medicine, Vienna, Austria, 15Hanusch Hospital, Department of Internal Medicine, Vienna, Austria, 16Hospital Elisabethinen Linz, Department of Internal Medicine IV, Linz, Austria, 17Hospital Feldkirch, Department of Internal Medicine, Feldkirch, Austria, 18Hospital Brothers of St. John of God Graz, Department of Internal Medicine II, Graz, Austria, 19Hospital Brothers of St. John of God Salzburg, Department of Internal Medicine, Salzburg, Austria

Background

inflammatory bowel diseases (IBD) are lifelong conditions challenging the patient not only with respect to somatic complaints but also affecting psychosocial issues. This may lead to the need for additional psychological care. The present study investigated the patients’ subjective need for additional psychological care and indicators for such a need.

Methods

We performed a cross-sectional multicentre study on Austrian IBD patients who were in routine care at one of the 18 participating IBD centres. The patients were asked to fill in a questionnaire booklet including the ADAPT, a validated questionnaire on the need for psychological care which gives two separate scores (‘ADAPT-IPC’ -need for integrated psychosomatic care, ‘ADAPT-PT’- need for psychotherapy), a validated questionnaire on the use of complementary and alternative medicine (CAM), the SIBDQ, and questions on clinical and sociodemographic data. The primary endpoint was the need for integrated psychosomatic care, psychotherapy or both.

Results

1286 patients returned the questionnaire. In total, 29.7% of all patients expressed a need for additional psychological care, 18.6% expressed a need for ADAPT-IPC and 20.2% expressed a need for ADAPT-PT. The multivariable regression analysis revealed the two dominating factors associated with the need for both types of psychological care were the use of CAM and a low SIBDQ-score ≤ 50 (see Table for details).

Table.
ADAPT-IPCADAPT-PT
OR95% CIOR95% CI
geographic region 0.570.301.100.910.501.67
Education
2 vs. 10.630.400.981.020.661.55
3 vs. 11.160.721.861.781.132.81
Age at inclusion1.02*1.001.030.980.971.00
CAM use1.65**1.142.381.84**1.282.66
SIBDQ0.95**0.940.960.96**0.940.97
Glucocorticoids0.910.601.381.090.721.64
Infliximab1.230.851.780.780.541.12
Immunosuppressants0.720.481.080.930.621.38
Disease duration0.980.961.011.031.001.05

1= Primary school/compulsory education.

2= secondary school graduates.

3= Academic schools, University degree.

*p < 0.05; **p < 0.01.

Conclusion

About 30% of the Austrian IBD patients expressed a need for integrated psychosomatic therapy a/o psychotherapy. This need was especially associated with reduced quality of life and the use of CAM which may indicate the desire for emphathetic and dedicated care. Further studies will be necessary to clarify if these results can be reproduced in other countries.