title: Snapshot of an integrated psychosocial gastroenterology service.
abstract: OBJECTIVE
  To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization.
  
  
  METHODS
  Patients were referred by their gastroenterologists for psychological treatment during a 15 mo period. Patients seen for an intake with a psychologist completed the Brief Symptom Inventory (BSI) and a checklist of psychosocial concerns. A subset of patients with functional bowel disorders also completed a disease specific quality of life measure. Chart review was conducted to obtain information on type and frequency of sessions with the psychologist, the number of outpatient gastroenterology visits, and number of gastroenterology-related medical procedures during the 6 mo following psychological intake.
  
  
  RESULTS
  Of 259 patients referred for treatment, 118 (46%) completed an intake with a psychologist. Diagnoses included: irritable bowel syndrome (42%), functional dyspepsia (20%), inflammatory bowel diseases (20%), esophageal symptoms (10%), and "other" (8%). Demographic variables and disease type did not differentiate between those who did and did not schedule an intake. Mean t-scores for the BSI global score index and the depression, anxiety, and somatization subscales fell below the cutoff for clinical significance (t = 63). Treatments were predominantly gut-directed hypnosis (48%) and cognitive behavioral therapy (44%). Average length of treatment was 4 sessions. Among functional gastrointestinal (GI) patients, those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake [t (197) = 2.69, P < 0.01].
  
  
  CONCLUSIONS
  Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions.
authors: Sarah W Kinsinger, Sarah Ballou, Laurie Keefer, Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
authors: Sarah W
authors: SW
authors: Kinsinger
authors: Sarah W Kinsinger, Sarah Ballou, Laurie Keefer, Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
authors: Sarah
authors: S
authors: Ballou
authors: Sarah W Kinsinger, Sarah Ballou, Laurie Keefer, Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States.
authors: Laurie
authors: L
authors: Keefer
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D057189:Checklist; D002641:Chicago; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D005260:Female; D005762:Gastroenterology / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cognitive-behavioral therapy; Functional gastrointestinal disorders; Hypnosis; Irritable bowel syndrome; Psychological treatment