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Gastroenterol Hepatol. 2018 Feb;41(2):118-127. doi: 10.1016/j.gastrohep.2017.10.003. Epub 2017 Dec 21.

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.

[Article in English, Spanish]

Author information

1
Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Complexo Universitario de Santiago de Compostela, Santiago de Compostela, España. Electronic address: manubarreiro@hotmail.com.
2
Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato digestivo e Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital Gregorio Marañón, Madrid, España.
3
ACCU Madrid, Madrid, España.
4
Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato digestivo, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
5
Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Hospital Clínico San Carlos, Madrid, España.
6
Positivamente Centro de Psicología, Madrid, España.
7
Confederación de Asociaciones de Enfermos de Crohn y Colitis Ulcerosa de España (ACCU España), Madrid.
8
Unidad de Enfermedad Inflamatoria Intestinal, UGC Aparato Digestivo, Hospital Virgen de la Victoria, Málaga, España.
9
Hospital Clínico Universitario de Valencia, Universitat de Valencia, Valencia, España.
10
Corporación Sanitaria ParcTaulí, Sabadell, España.
11
Unidad de Atención Crohn-Colitis, Servicio de Aparato Digestivo, Hospital Universitario Valld'Hebron, Barcelona, España.
12
Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España.
13
Hospital Clínico Universitario de Valladolid, Valladolid, España.
14
Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Complexo Universitario de Santiago de Compostela, Santiago de Compostela, España.
15
Hospital Universitario Son Espases, Palma de Mallorca, España.
16
Hospital Universitari i Politècnic La Fe, CIBEREHD, Valencia, España.
17
Servicio de Aparato Digestivo, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
18
Hospital Universitario GermansTrias i Pujol, Badalona, España.
19
Hospital Universitario de Cruces, Baracaldo, España.
20
Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, España.
21
Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, España.
22
Hospital General Universitario de Alicante, Alicante, España.
23
Complexo Hospitalario Universitario de Ourense, Orense, España.
24
Hospital Universitario Mutua de Terrassa CIBERehd, Terrasa, España.

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

PMID:
29275001
DOI:
10.1016/j.gastrohep.2017.10.003
[Indexed for MEDLINE]

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