P100 Outcomes of a clinical psychology intervention in a UK IBD service

IntroductionPatients with IBD experience significant psychological distress. A variety of interventions to ameliorate this distress have been studied. However, to date no European study has assessed the impact on patients of a clinical psychologist embedded within the IBD team. Clinical psychology is uniquely characterised by its use of a patient/therapist collaborative formulation to guide and select from a variety of evidenced based psychological therapeutic treatment options. Such an approach is likely to be particularly beneficial for patients with IBD who may present with a wide range of needs from adjustment at diagnosis to coping with symptoms, adhering to treatment protocols and managing an on-going relationship with a medical team.MethodsA novel clinical psychology service was established within an existing IBD service at a large UK tertiary centre. Patients were referred either by a gastroenterologist, IBD nurse, or dietician using real world clinical selection (clinical judgement rather than screening/threshold methods). Patients could also self-refer to the service. After an assessment with the clinical psychologist, patients were assigned as either accepted for intervention, referred to other mental health services or did not require intervention. Intervention involved a range of therapeutic modalities delivered by a clinician with considerable experience of working with long-term physical health conditions.Abstract P100 Figure 1Pre- and post-intervention measures of depression (PHQ-9,A), anxiety (GAD-7, B), work and social adjustment (WSAS, C) and IBD-related quality of life (IBDQ, D). (A) and (B) also show distribution of PHQ9 and GAD7 scores in an unselected background population of IBD patients attending outpatient dinics at our centre.ResultsOf 42 patients referred, 25 (60%) were accepted for intervention, with completion data currently available for 21. Measures of depression, anxiety, work and social adjustment and health related quality of life were captured for these patients pre-, during and post-intervention, as well as for 93 unselected patients with IBD attending outpatient clinics. Patients selected for intervention recorded moderate to severe scores across these domains that differed significantly from the background population. Post-intervention, patients showed highly statistically significant improvement across all domains with scores that did not differ from the background.ConclusionsReal world clinical selection methods app