Psychological distress is highly prevalent in inflammatory bowel disease: A survey of psychological needs and attitudes.

Antonina Mikocka‐Walus,Paul Pavli,Wayne Massuger,Stephanie Buckton,Leanne Raven,Gregory T Moore,Simon R Knowles,William Connell,Jane M Andrews

doi:10.1002/jgh3.12236

Abstract

Background and AimData on patient needs and access to psychological services in inflammatory bowel disease (IBD) are scarce. This study aimed to describe the levels of distress and the needs, attitudes, and access to psychological services for people within Australia against established Australian IBD Standards.MethodsAn online cross‐sectional survey was conducted with Australians ≥16 years old recruited via Crohn's & Colitis Australia membership, public and private clinics, and the Royal Flying Doctor Service. K10 was used to measure psychological distress. The Chi‐square test was used to compare those with and without distress on key variables.ResultsOverall, 731 respondents provided complete data (71.5% female, mean age 46.5 years). Overall, 50% of respondents reported distress; only 15.2% were currently seeing a mental health practitioner; only 16.1% were asked about their mental health by their IBD specialist or IBD nurse; and only 12.2% reported access to a mental health practitioner as part of their IBD service. Those with psychological distress were significantly less satisfied with their IBD care; more commonly hospitalized; had an active disease, fistula or perianal disease, pain, or fatigue; and were receiving steroids, opioids, or antidepressants (all P < 0.05). As many as 68.2% of those with severe distress were not seeing a mental health practitioner.ConclusionsThe integrated biopsychosocial model of health care, with regular mental health screening and good access to mental health professionals, is requested by people living with IBD to improve their outcomes.

Highlights

Inflammatory bowel disease (IBD) affects 5 million people around the world, with an estimated 85 000 Australians having Crohn’s disease, ulcerative colitis, or indeterminate colitis
The Australian inflammatory bowel disease (IBD) Standards[12] detail the optimal quality of care in IBD; there are no studies examining how real-life health care compares to the Standards
The present study is the largest survey of mental health needs, attitudes, and access to mental health services in people living with IBD in Australia.[17]

Summary

Introduction

Inflammatory bowel disease (IBD) affects 5 million people around the world, with an estimated 85 000 Australians having Crohn’s disease, ulcerative colitis, or indeterminate colitis. 50% of respondents reported distress; only 15.2% were currently seeing a mental health practitioner; only 16.1% were asked about their mental health by their IBD specialist or IBD nurse; and only 12.2% reported access to a mental health practitioner as part of their IBD service. Those with psychological distress were significantly less satisfied with their IBD care; more commonly hospitalized; had an active disease, fistula or perianal disease, pain, or fatigue; and were receiving steroids, opioids, or antidepressants (all P < 0.05). Conclusions: The integrated biopsychosocial model of health care, with regular mental health screening and good access to mental health professionals, is requested by people living with IBD to improve their outcomes

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