PTU-124 The Treatment Needs of Patients with Gastrointestinal Disorders in Tertiary Functional Versus Pooled Psychology Clinics

Abstract

Introduction Psychological and physical co-morbidity is associated with poorer outcomes and higher service use for patients with gastrointestinal (GI) disorders. This study aimed to evaluate the treatment needs of patients with GI disorders in tertiary functional versus pooled GI psychology clinics. Methods 67 patients (49 females; mean age 42; range 17–86) completed questionnaires on accessing a tertiary functional (n = 36) and pooled (all causes) GI psychology clinic (n = 31). The Gastrointestinal Symptom Rating Scale (GSRS), Work and Social Adjustment Scale (WSAS), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Questionnaire (GAD-7) and Visceral Sensitivity Index (VSI) were completed. Mann-Whitney U-test was used for comparison of samples. Results Severity across measures was high amongst both samples. 31% of tertiary functional patients (n = 35) and 37% of pooled GI psychology (n = 30) patients scored within the ‘severe range’ for all three areas of need; GI symptom severity, functional impairment and distress. 67% of patients within the tertiary clinic were above cut off for clinically significant distress compared with 90% in the pooled GI psychology clinic. No significant differences were found between the two groups of patients for GI symptom severity (U = 527, p = 0.697), functional impairment (U = 532, p = 0.951), GI-specific distress (U = 502.5, p = 0.949) or depression (U = 403, p = 0.078). Patients seen within the GI Psychology clinic scored significantly higher for generalised anxiety (U = 350, p = 0.014). Conclusion Clinically significant high levels of GI symptom severity, functional impairment and psychological distress were reported across the samples. This was expected as referral indication to the pooled GI psychology clinic, but surprisingly high in the tertiary functional clinic. This supports developing integrated psychological services within this GI sub–speciality to provide interventions for health-related distress. Generalised anxiety was significantly higher within the pooled psychology sample. Future studies may determine whether GI patients with less overt anxiety, but nonetheless significant psychological needs, are at risk of under-referral to psychology. Use of questionnaires may identify psychological co-morbidity within gastroenterology services to triage appropriate and timely referrals for psychological therapy. Disclosure of Interest None Declared