Department of Internal Medicine.
The University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, Winnipeg.
J Clin Gastroenterol. 2024;58(5):464-470. doi: 10.1097/MCG.0000000000001892. Epub 2023 Jul 21.
Psychiatric comorbidity is common in inflammatory bowel disease (IBD) and can negatively affect disease outcomes. We explored the perceived need for mental health care among persons with IBD.
Persons with IBD completed self-report questionnaires, including the Hospital Anxiety and Depression Scale (HADS), and reported whether they wanted help with their mood. Each was also assessed using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorders (SCIDs). We used logistic regression analyses to determine factors associated with the perceived need for mental health care.
Of 245 participants, 28% met the criteria for a past diagnosis of depression or anxiety disorder by SCID, and nearly 23% met the criteria for a current diagnosis of depression or anxiety disorder. One-third (n = 74) reported a perceived need for mental health care. Among those meeting criteria for a current SCID diagnosis of depression or anxiety, only 58% reported needing mental health care. Need for mental health care was reported by 79% of persons currently treated for either depression or 71% treated for anxiety. Persons with a perceived need for mental health care had higher mean HADS for depression and HADS for anxiety scores and also higher IBD symptom activity scores. Of those reporting no perceived need for mental health care, 13% had a current diagnosis of depression or anxiety disorder by SCID; even fewer had symptoms of depression or anxiety.
Symptoms of depression or anxiety are more important than a formal diagnosis of depression or anxiety in predicting which persons with IBD will perceive a need for mental health care.
精神共病在炎症性肠病（IBD）中很常见，并且可能对疾病结局产生负面影响。我们探讨了 IBD 患者对心理健康护理的需求。
IBD 患者完成了自我报告问卷，包括医院焦虑和抑郁量表（HADS），并报告他们是否需要帮助改善情绪。每位患者还接受了 DSM-IV-TR 轴 I 障碍的结构化临床访谈（SCID）评估。我们使用逻辑回归分析来确定与心理健康护理需求相关的因素。
在 245 名参与者中，28%符合 SCID 过去诊断为抑郁或焦虑障碍的标准，近 23%符合当前诊断为抑郁或焦虑障碍的标准。三分之一（n = 74）报告有心理健康护理的需求。在符合当前 SCID 抑郁或焦虑诊断标准的患者中，只有 58%报告需要心理健康护理。正在接受抑郁治疗的患者中有 79%和正在接受焦虑治疗的患者中有 71%报告需要心理健康护理。需要心理健康护理的患者 HADS 抑郁和 HADS 焦虑评分的平均值较高，并且 IBD 症状活动评分也较高。在报告没有心理健康护理需求的患者中，13%通过 SCID 诊断为当前抑郁或焦虑障碍；仅有更少的患者有抑郁或焦虑症状。
抑郁或焦虑症状比抑郁或焦虑的正式诊断更能预测哪些 IBD 患者会感知到需要心理健康护理。
