Which patients with IBD need psychological interventions? A controlled study.
BACKGROUND
Psychological distress is frequent in inflammatory bowel disease (IBD). Whether there is a need for psychological interventions is unknown. This study investigated the quantity and quality of the need for psychological interventions in IBD as compared to rheumatoid arthritis (RA).


METHODS
In all, 302 patients with IBD and 109 patients with RA answered the ADAPT questionnaire, assessing the need for psychosomatic support (physicians support) and for psychotherapy, the hospital anxiety and depression scale, the SF-36, a questionnaire on social support (SOZU-K22), and the Rating Form of IBD Patient Concerns (IBD patients only). Detailed biomedical data were also assessed.


RESULTS
Ninety-three patients with IBD (31%) expressed a need for psychological intervention compared to 14 patients with RA (13%; P < 0.001). Stepwise logistic regression analysis revealed that anxiety (odds ratio [OR] 3.6; 95% confidence interval [CI] 2.2-6.0; P < 0.001), age < or =44 years (OR 2.6; 95% CI 1.5-4.3; P < 0.001) and impaired social support (SOZU-K22 <4.20) (OR 2.0; 95% CI 1.2-3.3; P = 0.009) accounted for this difference. In IBD the need for psychosomatic (physicians) support was associated with worries and concerns about IBD and the need for psychotherapy was associated with worries and concerns about IBD, anxiety, impaired "social functioning" (SF-36), and short disease duration.


CONCLUSIONS
Patients with IBD express a higher need for psychological interventions than patients with RA due to greater psychosocial restrictions inherent in IBD. The need for psychological interventions was characterized by psychological factors, mainly worries about the disease and anxiety, rather than by medical variables
Miehsler
Wolfgang
W
Department of Internal Medicine III, Division of Gastroenterology and Hepatology, University of Vienna, Austria. wolfgang.miehsler@meduniwien.ac.at
Weichselberger
Martina
M
Offerlbauer-Ernst
Anna
A
Dejaco
Clemens
C
Reinisch
Walter
W
Vogelsang
Harald
H
Machold
Klaus
K
Stamm
Tanja
T
Gangl
Alfred
A
Moser
Gabriele
G
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D018401:Sample Size; D012944:Social Support; D011795:Surveys and Questionnaires