Knowles Simon, Andrews Jane M, Porter Anna
Simon Knowles, PhD, is with Faculty of Health, Arts and Design, Swinburne University of Technology, Department of Gastroenterology, Royal Melbourne Hospital, and Department of Psychiatry, The Melbourne University, Melbourne, Victoria, Australia. Jane M. Andrews, MBBS, PhD, FRACP, is Consultant Gastroenterologist, Head IBD Service & Education, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, South Australia, Australia. Anna Porter, BAgrEcon (Hons), is Market Access Manager, AbbVie, Mascot, New South Wales, Australia.
Gastroenterol Nurs. 2018 Jan/Feb;41(1):38-46. doi: 10.1097/SGA.0000000000000251.
This study explored the possible factors associated with psychological distress in adults with inflammatory bowel disease (IBD) and also engagement in mental health services (MHS) in those reporting distress in a large Australian cohort. Participants with IBD completed an online survey assessing perceived IBD activity (Manitoba Index; MI), mental health status (K10), demographic details, and engagement with MHS for IBD-associated issues. Of 336 participants, 76.5% perceived themselves as having active disease over the past 6 months, and on K10 scores, 51.8% had a mental health issue. Of participants with a mental health issue, only 21.3% were currently receiving mental health support. A stepwise logistic regression analysis correctly classified 78.7% of the status of receiving mental health support, with lower income (<$60,000 per annum) the only significant predictor. Paradoxically, the degree of psychological distress did not correlate with seeking mental health support. The data show that in individuals with ongoing symptoms attributed to active IBD, mental health issues are highly prevalent, with older age and higher income being additional drivers of mental health issues. The greater challenge, however, seems not to be identifying mental health issues, but in getting those in need to engage in MHS.
本研究在一个大型澳大利亚队列中，探究了炎症性肠病（IBD）成年患者心理困扰的可能相关因素，以及那些报告有困扰的患者接受心理健康服务（MHS）的情况。IBD患者完成了一项在线调查，评估其感知到的IBD活动情况（马尼托巴指数；MI）、心理健康状况（K10）、人口统计学细节，以及因IBD相关问题接受MHS的情况。在336名参与者中，76.5%的人认为自己在过去6个月患有活动性疾病，根据K10评分，51.8%的人存在心理健康问题。在有心理健康问题的参与者中，目前只有21.3%的人正在接受心理健康支持。逐步逻辑回归分析正确分类了78.7%的接受心理健康支持的状况，其中低收入（每年<60,000美元）是唯一的显著预测因素。矛盾的是，心理困扰程度与寻求心理健康支持并无关联。数据显示，在有活动性IBD所致持续症状的个体中，心理健康问题非常普遍，年龄较大和收入较高是心理健康问题的额外驱动因素。然而，更大的挑战似乎不是识别心理健康问题，而是让有需要的人接受MHS。
