Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients

Gastroenterol Hepatol. 2018 Feb;41(2):118-127. doi: 10.1016/j.gastrohep.2017.10.003. Epub 2017 Dec 21.
[Article in English, Spanish]

Abstract

Aims: To establish recommendations for the management of psychological problems affecting patients with inflammatory bowel disease (IBD).

Methods: A meeting of a group of IBD experts made up of doctors, psychologists, nurses and patient representatives was held. The following were presented: 1) Results of a previous focal group, 2) Results of doctor and patient surveys, 3) Results of a systematic review of tools for detecting anxiety and depression. A guided discussion was then held about the most important psychological and emotional problems associated with IBD, appropriate referral criteria and situations to be avoided. The validated instrument most applicable to clinical practice was selected. A recommendations document and a Delphi survey were designed. The survey was sent to the group and to a scientific committee of the GETECCU group in order to establish the level of agreement with these recommendations.

Results: Fifteen recommendations were established linked to 3 key processes: 1) What steps should be taken to identify psychological problems at an IBD appointment; 2) What are the criteria for referring patients to a mental health specialist; 3) How to approach psychological problems.

Conclusions: Resources should be made available to healthcare professionals so that they can treat these problems during consultations, identify the disorders which could affect the clinical course of the disease and determine their impact on the patient's life in order that these can be treated and followed up by the most suitable professional. These recommendations could serve as a basis for redesigning IBD services or processes and as justification for the training of healthcare personnel.

Keywords: Ansiedad; Anxiety; Aspectos psicológicos; Clinical practice guidelines; Colitis ulcerosa; Crohn's disease; Depresión; Depression; Enfermedad de Crohn; Enfermedad inflamatoria intestinal; Guías de práctica clínica; Inflammatory bowel disease; Psychological problems; Ulcerative colitis.

Publication types

  • Consensus Development Conference
  • Practice Guideline
  • Systematic Review

MeSH terms

  • Affective Symptoms / diagnosis
  • Affective Symptoms / drug therapy
  • Affective Symptoms / etiology
  • Anti-Anxiety Agents / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / etiology
  • Depressive Disorder / diagnosis
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / etiology
  • Disease Management
  • Emotions
  • Humans
  • Inflammatory Bowel Diseases / psychology*
  • Quality of Life
  • Risk Factors
  • Sexual Dysfunctions, Psychological / etiology

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents