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Management of the Psychological Impact of Inflammatory Bowel Disease: Perspective of Doctors and Patients—The ENMENTE Project

Marín-Jiménez, Ignacio MD*; Gobbo Montoya, Milena BSc; Panadero, Abel BSc; Cañas, Mercedes BSc§; Modino, Yolanda BSc; Romero de Santos, Cristina BPharm; Guardiola, Jordi MD**; Carmona, Loreto MD, PhD††; Barreiro-de Acosta, Manuel MD, PhD‡‡

doi: 10.1097/MIB.0000000000001205
IBD LIVE Articles

Background: To explore the perception of patients and gastroenterologists specialized in inflammatory bowel disease (IBD) on the impact of psychological factors on IBD course and its management.

Methods: Online surveys were sent to patients with IBD recruited from a national patient association and IBD specialists recruited from a national scientific society. These surveys were based on the results of a focus group and discussion group that explored the psychological aspects of IBD. Descriptive statistical analyses were performed, and the physicians' responses regarding impact and management were compared with those of a random patient sample.

Results: Responses were obtained from 170 physicians and 903 patients. Most patients emphasized the impact of psychological aspects, namely anxiety and depression, related to suffering from IBD, with 28% declaring that they perceived health professionals to not be interested in this area. A third of the physicians declared not feeling qualified to detect psychological problems. Although 50% of doctors stated that they regularly enquire about these aspects in their clinics, the patients perceived that this was done only 25% of the time. Both groups agreed on the need of a psychologist in IBD care teams.

Conclusions: A discrepancy exists between physician and patient perceptions of the impact of psychological aspects in IBD, with patients perceiving higher impact and more under treatment than physicians. Given the influence of these aspects on patient well-being, it seems advisable to enrich professionals' training, improve the clinical management of psychological aspects of IBD, and probably include psychologists in IBD care teams.

Article first published online 3 August 2017.

*Gastroenterology Department, Institute of Medical Research Gregorio Marañón (IiSGM); Hospital General Universitario Gregorio Marañón, Madrid, Spain;

Positivamente, Centro de Psicología, Madrid, Spain;

Confederation of Associations of Crohn's Disease and Ulcerative Colitis of Spain (ACCU), Madrid, Spain;

§Inflammatory Bowel Disease Unit, Gastroenterology Department, Hospital Clínico San Carlos, Madrid, Spain;

Confederation of Associations of Crohn's Disease and Ulcerative Colitis of Spain (ACCU España), Madrid, Spain;

Merck Sharp & Dohme España, Madrid, Spain;

**Inflammatory Bowel Disease Unit, Gastroenterology Department; Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain;

††Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain; and

‡‡Inflammatory Bowel Disease Unit, Gastroenterology Department, Complexo Universitario de Santiago de Compostela, Santiago, Spain.

Address correspondence to: Ignacio Marín-Jiménez, MD, Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46, 28007 Madrid, Spain (e-mail: drnachomarin@hotmail.com).

The project received financial support from Merck Sharp & Dohme of Spain, a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ.

I. Marín-Jiménez has been speaker, consultant, and participated in advisory meetings and/or has received research support from MSD, AbbVie, Hospira, Takeda, Janssen, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Gebro Pharma, Otsuka Pharmaceuticals, AstraZeneca, and Tillotts Pharma. M. Barreiro-de Acosta has been speaker, consultant, and participated in advisory meetings and/or has received research support from MSD, AbbVie, Hospira, Takeda, Kern, Janssen, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Gebro Pharma, Otsuka Pharmaceuticals, and Tillotts Pharma. The remaining authors have no conflict of interest to disclose.

Received March 10, 2017

Accepted May 24, 2017

© Crohn's & Colitis Foundation
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