Comprehensive psychological intervention to improve outcome in functional gastrointestinal disorder: a cohort study
| Autor: | Yu Tien Wang, Shian Ming Tan, Wai Choung Ong, Sylvaine Barbier, Kah Foo Victor Kwok, Ming Hwei Yek, Beng Yeong Ng |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Gastrointestinal Diseases Psychological intervention Anxiety Severity of Illness Index Functional gastrointestinal disorder Quality of life Surveys and Questionnaires Severity of illness medicine Humans Psychiatry Depression (differential diagnoses) Singapore Depression business.industry Mental Disorders Follow up studies General Medicine Middle Aged medicine.disease Treatment Outcome Quality of Life Physical therapy Original Article Female medicine.symptom business Follow-Up Studies Cohort study |
| Zdroj: | Singapore Medical Journal. 56:385-392 |
| ISSN: | 0037-5675 |
| DOI: | 10.11622/smedj.2015109 |
| Popis: | Patients with functional gastrointestinal disorders (FGIDs) have a decreased quality of life (QoL). Psychological illnesses are strongly associated with FGIDs. This study examined the effect of a comprehensive psychological intervention programme designed for refractory FGID patients.Refractory FGID patients at a tertiary gastroenterology unit were encouraged to participate in a psychological intervention programme, which included screening for anxiety and depression in patients, educating patients and physicians on FGIDs, and providing early access to psychiatric consultation for patients with significant psychological illnesses. The duration of follow-up was six months. Outcomes were measured using the Irritable Bowel Syndrome-QoL (IBS-QoL) instrument and the EuroQol five dimensions (EQ-5D) questionnaire.A total of 1,189 patients (68% female, 80% Chinese, mean age 48.6 years) participated in the programme. Among these participants, 51% had a significant psychological disorder (Hospital Anxiety and Depression Scale [HADS] anxiety or depression score7). These participants had a significantly poorer QoL (IBS-QoL and EQ-5D, both p0.0001), and were more likely to be single or English-speaking, as compared to the participants without psychological disorders. Participants who completed ≥ 3 months of follow-up (n = 906) showed significant and durable improvement. High baseline HADS anxiety score predicted improvement (p0.001), with participant IBS-QoL and EQ-5D scores decreasing over time.The intervention programme was associated with a clinically meaningful improvement in the QoL of patients with refractory FGIDs. High baseline anxiety was predictive of improvement. |
| Databáze: | OpenAIRE |
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