Bogale Kaleb, Yadav Sanjay, Stuart August, Kunselman Allen R, Dalessio Shannon, Bernasko Nana, Tinsley Andrew, Clarke Kofi, Williams Emmanuelle, Coates Matthew D
Penn State University College of Medicine, Hershey, Pennsylvania, USA.
Department of Psychiatry, Penn State University College of Medicine, Hershey, Pennsylvania, USA.
Inflamm Intest Dis. 2021 Nov 10;7(2):81-86. doi: 10.1159/000520797. eCollection 2022 Jul.
Psychiatric disorders, including anxiety and depression, are significantly more common in patients with inflammatory bowel disease (IBD). We established an integrated psychiatry clinic for IBD patients at our tertiary center IBD clinic to provide patients with critical, but frequently unavailable, coordinated mental health services. We undertook this study to evaluate the impact of this service on psychiatric outcomes, quality of life, and symptom experience.
We performed a longitudinal prospective study comparing patients who had been cared for at our integrated IBD-psychiatry clinic to those who had not. We abstracted demographic and clinical information as well as contemporaneous responses to validated surveys.
Thirty-six patients cared for in the IBD psychiatry clinic were compared to a control cohort of 35 IBD patients. There was a significant reduction in the Hospital Anxiety and Depression Scale (HADS) depression score over time in the study cohort ( = 0.001), though not in the HADS anxiety score. When compared to the control group, the study cohort showed a significant reduction in the HADS depression score. No significant differences were observed in the Harvey-Bradshaw Index, Simple Clinical Colitis Activity Index, or Short IBD Questionnaire.
This is the first study to evaluate the impact of an integrated psychiatry clinic for IBD patients. Unlike their control counterparts, individuals treated in this clinic had a significant reduction in the mean HADS depression score. Larger scale studies are necessary to verify these findings. However, this study suggests that use of an integrated psychiatry IBD clinic model can result in improvement in mental health outcomes, even in the absence of significant changes in IBD activity.
包括焦虑和抑郁在内的精神障碍在炎症性肠病（IBD）患者中明显更为常见。我们在三级中心的IBD诊所为IBD患者设立了一个综合精神病诊所，为患者提供关键但常常无法获得的协调心理健康服务。我们进行这项研究以评估这项服务对精神科结局、生活质量和症状体验的影响。
我们进行了一项纵向前瞻性研究，比较在我们的IBD-精神病综合诊所接受治疗的患者与未接受治疗的患者。我们提取了人口统计学和临床信息以及对有效调查问卷的同期回复。
将在IBD精神病诊所接受治疗的36例患者与35例IBD对照患者进行比较。研究队列中，医院焦虑抑郁量表（HADS）抑郁评分随时间显著降低（P = 0.001），但HADS焦虑评分未降低。与对照组相比，研究队列的HADS抑郁评分显著降低。在哈维-布拉德肖指数、简单临床结肠炎活动指数或IBD简短问卷中未观察到显著差异。
这是第一项评估IBD患者综合精神病诊所影响的研究。与对照组不同，在该诊所接受治疗的个体的平均HADS抑郁评分显著降低。需要更大规模的研究来验证这些发现。然而，这项研究表明，即使IBD活动没有显著变化，采用IBD-精神病综合诊所模式也可改善心理健康结局。
