{
  "abstract": "Introduction A small proportion of inflammatory bowel disease (IBD) teams have access to psychology services. There is little data to guide workforce planning in this area. The aims of this study are to assess the demand for an integrated psychology service within a cohort of IBD patients, and to explore their views of the support they require.Methods In this single-site, observational study adult IBD outpatients completed questionnaires regarding their history of mental health illness, willingness to engage with psychology services, and self-assessed their level of depression, anxiety and stress by completing the Depression, Anxiety, and Stress Scale-21 (DASS-21). Data was collected on participants’ healthcare use over the following four months. Participants were invited to engage in a focus group to gain deeper insights into their views. Questionnaire data was analysed to identify factors that were associated with higher DASS-21 scores using chi-square analysis. Logistic regression analysis assessed if higher levels of depression, anxiety and stress correlated to increased healthcare use. Focus group data was evaluated via reflexive thematic analysis to extract common themes and ideas.Results 123 patients were recruited. Seventy-nine (66%) had a moderate or severe score in at least one sub-category of depression, anxiety or stress. 39% reported body image issues, 46% noted impact on sexual relations, and 88% had impact on leisure, work or education. Patients with moderate or severe depression, anxiety or stress had a significantly higher use of the IBD helpline in the subsequent 4 month period (39% v 17%). Logistic regression analysis showed this difference remained significant, even when other patient factors including disease activity were controlled for (p<0.05).84% expressed a wish for a psychology service as part of their IBD care. Thematic analysis from the focus groups revealed patients felt psychological support was important due to it being a ‘lonely disease’, and described a ‘difficult and unpredictable journey’. Regarding the nature of psychological support, they felt a good understanding of IBD is essential, that the service needs to be accessible, and the role of a psychology service facilitating peer support should be considered.Conclusion We demonstrated high levels of mental health illness in this IBD cohort. It provides patient insight into the character and form of psychological support they require. For the vast majority of patients this remains an unmet need, and we’ve shown that patients are turning to alternative healthcare resources for support. Service planners need to consider how to design and resource a psychology service for IBD patients that meets their complex needs and remains accessible despite the high demand.",
  "authors": [
    {
      "affiliations": [
        "Cwm Taf Morgannwg University Health Board, Pontyclun, United Kingdom"
      ],
      "name": "Oliver Davies"
    },
    {
      "affiliations": [
        "Cardiff University, Cardiff, United Kingdom"
      ],
      "name": "Saisha-Mair Davies"
    },
    {
      "affiliations": [
        "Cwm Taf Morgannwg University Health Board, Pontyclun, United Kingdom"
      ],
      "name": "Lisa Deering"
    },
    {
      "affiliations": [
        "Cwm Taf Morgannwg University Health Board, Pontyclun, United Kingdom"
      ],
      "name": "Karan Edwards"
    },
    {
      "affiliations": [
        "Cardiff Metropolitan University, Cardiff, United Kingdom"
      ],
      "name": "Keith Morris"
    },
    {
      "affiliations": [
        "Cwm Taf Morgannwg University Health Board, Pontyclun, United Kingdom"
      ],
      "name": "Michelle Smalley"
    },
    {
      "affiliations": [
        "Cwm Taf Morgannwg University Health Board, Pontyclun, United Kingdom"
      ],
      "name": "James Berrill"
    }
  ],
  "title": "P204 More than the gut: psychological morbidity and demand for integrated care in inflammatory bowel disease",
  "uid": "18808be5-c5bc-510c-8462-99b482749616"
}