scholarly journals Implementing Collaborative Care Management of Behavioral Health for Patients with Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Christine Beran ◽  
Nathaniel A. Sowa ◽  
Millie D. Long ◽  
Hans H. Herfarth ◽  
Spencer D. Dorn
Keyword(s):  
Inflammatory Bowel Disease ◽  
Behavioral Health ◽  
Collaborative Care ◽  
Bowel Disease ◽  
Care Management ◽  
Care Delivery ◽  
Clinical Impression ◽  
Depression And Anxiety ◽  
Medical Provider ◽  
Inflammatory Bowel

Background Individuals with inflammatory bowel disease (IBD) are up to twice as likely to suffer from anxiety and/or depression. Collaborative care management (CoCM) is an evidenced-based approach to treating behavioral health disorders that has proven effective for a range of conditions in primary care and some specialty settings. This model involves a team-based approach, with care delivered by a care manager (case reviews and behavioral therapy), psychiatrist (case reviews and psychopharmacological recommendations), and medical provider (ongoing care including psychopharmacological prescriptions). We assessed the feasibility and effectiveness of CoCM in reducing anxiety and depressive symptoms in patients with IBD. Methods Patients with psychological distress identified by clinical impression and/or the results of the Patient Health Questionaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were referred to the CoCM program. Data from our 9-month CoCM pilot were collected to assess depression and anxiety response and remission rates. We obtained provider surveys to assess provider acceptability with delivering care in this model. Results Though the coronavirus SARS-CoV2 (COVID-19) pandemic interrupted screening, 39 patients enrolled and 19 active participants completed the program. Overall, 47.4% had either a response or remission in depression, while 36.8% had response or remission in anxiety. The gastroenterologists highly agreed that the program was a beneficial resource for their patients and felt comfortable implementing the recommendations. Discussion CoCM is a potentially feasible and well accepted care delivery model for treatment of depression and anxiety in patients with IBD in a specialty gastroenterology clinic setting

scholarly journals Prevalence of Anxiety and Depression in Patients with Inflammatory Bowel Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Glynis Byrne ◽  
Greg Rosenfeld ◽  
Yvette Leung ◽  
Hong Qian ◽  
Julia Raudzus ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Multivariable Analysis ◽  
Significant Proportion ◽  
Mental Illnesses ◽  
Self Report ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Psychiatric Interview ◽  
Inflammatory Bowel

Background. Inflammatory bowel disease (IBD) patients are not routinely screened for depression and anxiety despite knowledge of an increased prevalence in people with chronic disease and negative effects on quality of life. Methods. Prevalence of anxiety and depression was assessed in IBD outpatients through retrospective chart review. The presence of anxiety and/or depression was determined using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 self-report questionnaires or by diagnosis through psychiatric interview. Patient demographics, disease characteristics, and medication information were also collected. Multivariable analysis was used to determine associations between patient factors and depression and anxiety. Results. 327 patient charts were reviewed. Rates of depression and anxiety were found to be 25.8% and 21.2%, with 30.3% of patients suffering from depression and/or anxiety. Disease activity was found to be significantly associated with depression and/or anxiety (p=0.01). Females were more likely to have anxiety (p=0.01). Conclusion. A significant proportion of IBD patients suffer from depression and/or anxiety. The rates of these mental illnesses would justify screening and referral for psychiatric treatment in clinics treating this population. Patients with active disease are particularly at risk for anxiety and depression.

scholarly journals Controversies surrounding the comorbidity of depression and anxiety in inflammatory bowel disease patients

2007 ◽  
Vol 13 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Antonina A. Mikocka-Walus ◽  
Deborah A. Turnbull ◽  
Nicole T. Moulding ◽  
Ian G. Wilson ◽  
Jane M. Andrews ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Depression And Anxiety ◽  
Inflammatory Bowel

scholarly journals The Symptoms and Medications of Patients with Inflammatory Bowel Disease in Hubei Province after COVID-19 Epidemic

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Huan Wang ◽  
Lei Tu ◽  
Ying Li ◽  
Tao Bai ◽  
Kaifang Zou ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Online Survey ◽  
Gastrointestinal Symptoms ◽  
Life Quality ◽  
Scoring Systems ◽  
Hubei Province ◽  
Depression And Anxiety ◽  
Psychological Issues ◽  
Inflammatory Bowel

Objectives. The COVID-19 epidemic triggered by coronavirus SARS-CoV-2 is rapidly spreading around the globe. This study is aimed at finding out the suspected or confirmed SARS-CoV-2 infection in patients with inflammatory bowel disease (IBD) in Hubei province, China. We also investigated symptoms, medications, life quality, and psychological issues of IBD patients under the ongoing pandemic. Methods. We conducted a self-reported questionnaire survey via an online survey platform. SARS-CoV-2 infection-related data was collected from IBD patients. The status quo of medications and symptoms of the subjects were investigated. Life quality, depression, and anxiety were measured by clinical questionnaires and rated on scoring systems. Results. A total of 204 IBD patients from Hubei province were included in this study. No suspected or confirmed SARS-CoV-2 infection case was found in this study. As a result of city shutdown, two-thirds of the patients (138/204) in our series reported difficulty in accessing medicines and nearly half of them (73/138) had to discontinue medications. Apart from gastrointestinal symptoms, systemic symptoms were common while respiratory symptoms were rare in the cohort. Though their quality of life was not significantly lowered, depression and anxiety were problems that seriously affected them during the COVID-19 epidemic. Conclusions. Inaccessibility to medications is a serious problem for IBD patients after city shutdown. Efforts have to be made to address the problems of drug withdrawal and psychological issues that IBD patients suffer from during the COVID-19 outbreak.

scholarly journals P314 C-Reactive protein is associated with depression and anxiety in patients with inflammatory bowel disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S311-S311
Author(s):  
T Rodriguez ◽  
J Karpin ◽  
C Traboulsi ◽  
V Rai ◽  
D Rubin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Patient Characteristics ◽  
Adaptive Testing ◽  
Prior History ◽  
Depression And Anxiety ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Severity Scores ◽  
Inflammatory Bowel

Abstract Background Depression and anxiety are comorbidities of inflammatory bowel disease (IBD). Though previous studies have proposed a relationship between anxiety, depression and IBD, causality and directionality are unknown. We used a novel computerised adaptive testing technology to screen IBD patients for depression and anxiety and compared the screening results to recent measures of C-reactive protein (CRP). Methods Consecutive patients at our tertiary IBD clinic were asked to complete the validated CAT-MH™ survey from Adaptive Testing Technologies (Chicago, IL); we then reviewed disease and patient characteristics. CRP measures from within 6 months of survey administration were used and levels ≥5 mg/l were considered positive. Patients who are CRP non-reactive were excluded. Pearson Chi-Square test was used to assess correlation. Results 134 patients (75 women, 112 Caucasian, 84 Crohn’s disease) participated in the study, 85 of whom had no prior history of psychiatric disorders. We identified 51 patients with depression (46 mild, 3 moderate, 2 severe) and 36 subjects with anxiety (24 mild, 10 moderate, 2 severe). Of the 134 patients recruited for this study, 57 had CRP reported. Median time between CRP measurement and CAT-MH™ administration was 2 days (IQR = 70). Categorical analysis stratified patients with positive and negative CRP who are also positive for depression and/or anxiety. Compared with patients with negative CRP values, patients with positive CRP were more likely to also test positive for depression and anxiety. These results were statistically significant for depression (p = 0.008) and nearly significant for anxiety (p = 0.058) (Figure 1). Quartile analysis of the 21 patients with elevated CRP levels revealed an increasing trend of average depression and anxiety severity scores. However, this correlation was lost when CRP >21 mg/l (Figure 2). Conclusion We illustrate the significant association between CRP and depression and anxiety severity scores on the CAT-MH™ survey. These findings suggest a positive relationship between inflammation and depression and anxiety in IBD patients. Physicians should consider patients with elevated CRP levels at risk for these mental health conditions.

scholarly journals The Validity and Reliability of Screening Measures for Depression and Anxiety Disorders in Inflammatory Bowel Disease

2018 ◽  
Vol 24 (9) ◽  
pp. 1867-1875 ◽  
Author(s):  
Charles N Bernstein ◽  
Lixia Zhang ◽  
Lisa M Lix ◽  
Lesley A Graff ◽  
John R Walker ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Anxiety Disorders ◽  
Bowel Disease ◽  
Depression And Anxiety ◽  
Validity And Reliability ◽  
Inflammatory Bowel ◽  
Screening Measures

Resilience is Associated with Lower Rates of Depression and Anxiety, and Higher Quality of Life in Inflammatory Bowel Disease Patients

2017 ◽  
Vol 152 (5) ◽  
pp. S797-S798 ◽  
Author(s):  
Priya Sehgal ◽  
Elizabeth Abrahams ◽  
Ryan C. Ungaro ◽  
Marla Dubinsky ◽  
Laurie Keefer
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Depression And Anxiety ◽  
Inflammatory Bowel

scholarly journals N15 Transition of care programme and treatment adherence in adolescents with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S615-S615
Author(s):  
N Garzia Stafrace
Keyword(s):  
Health Care ◽  
Inflammatory Bowel Disease ◽  
Treatment Adherence ◽  
Psychosocial Development ◽  
Bowel Disease ◽  
Care Delivery ◽  
Heart Diseases ◽  
Transition Of Care ◽  
Care Programme ◽  
Inflammatory Bowel

Abstract Background The purpose of this study was to address the grey areas influencing the transition of care (TOC) aspect in adolescents suffering from IBD. In the context of healthcare, the term ‘transition’ refers to a phase of development from one stage to another. ‘TOC’ is defined as the “purposeful planned movement of adolescents and young adults with chronic conditions from child-centred to adult-oriented health care systems” (Blum et al., 1993). The point where the adolescent becomes an adult represents a milestone not only in health care delivery but also in the wider context of knowledge of medication, education, and employment, as well as sexual and psychosocial development amongst others (Greveson et al., 2011). Although this concept of care is still in its early stages, it has found its application in various specialities of medicine, including but not limited to diabetes, juvenile rheumatology, congenital heart diseases (Afzali & Wahbeh, 2017) and gastroenterology conditions, namely inflammatory bowel disease (IBD). Methods From this systematic review of literature that discussed TOC, it became evident that this essential process is undervalued and understudied. Transition standards vary between healthcare services and goals. The selected 3 cross-sectional, 1 cohort and 1 multi-site comparison studies published between 2013 and 2018 analysed how IBD treatment compliance in adolescents is affected when going through an established TOC compared to no TOC. While TOC has successfully created clinical targets, identified deficiencies in knowledge, adherence, and transition readiness assessments, there are still few evidence-based tools to assist in the transition process and a relative absence of transition models that have been critically appraised (Bollegala & Nguyen, 2015). Results Findings determined that the establishment and attendance of IBD adolescent patients in structured TOC programmes or clinics ensure cohesive treatment adherence. Nevertheless, it was established that further studies must be carried out on the matter at hand. Conclusion Recommendations for clinical practice, management, education, and further studies were endorsed. Such suggestions concluded that transition should be delayed until the patient has been assessed for readiness, along with the importance of involving a multidisciplinary team and the development of practical guidelines and skills aimed for optimal, lifelong IBD management.

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