AIM:To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization.METHODS:Patients were referred by their gastroenterologists for ...AIM:To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization.METHODS:Patients were referred by their gastroenterologists for psychological treatment during a15 mo period.Patients seen for an intake with a psychologist completed the Brief Symptom Inventory(BSI)and a checklist of psychosocial concerns.A subset of patients with functional bowel disorders also completed a disease specific quality of life measure.Chart review was conducted to obtain information on type and frequency of sessions with the psychologist,the number of outpatient gastroenterology visits,and number of gastroenterology-related medical procedures during the 6 mo following psychological intake.RESULTS:Of 259 patients referred for treatment,118(46%)completed an intake with a psychologist.Diagnoses included:irritable bowel syndrome(42%),functional dyspepsia(20%),inflammatory bowel diseases(20%),esophageal symptoms(10%),and"other"(8%).Demographic variables and disease type did not differentiate between those who did and did not schedule an intake.Mean t-scores for the BSI global score index and the depression,anxiety,and somatization subscales fell below the cutoff for clinical significance(t=63).Treatments were predominantly gut-directed hypnosis(48%)and cognitive behavioral therapy(44%).Average length of treatment was 4 sessions.Among functional gastrointestinal(GI)patients,those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake[t(197)=2.69,P<0.01].CONCLUSION:Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions.展开更多
文摘AIM:To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization.METHODS:Patients were referred by their gastroenterologists for psychological treatment during a15 mo period.Patients seen for an intake with a psychologist completed the Brief Symptom Inventory(BSI)and a checklist of psychosocial concerns.A subset of patients with functional bowel disorders also completed a disease specific quality of life measure.Chart review was conducted to obtain information on type and frequency of sessions with the psychologist,the number of outpatient gastroenterology visits,and number of gastroenterology-related medical procedures during the 6 mo following psychological intake.RESULTS:Of 259 patients referred for treatment,118(46%)completed an intake with a psychologist.Diagnoses included:irritable bowel syndrome(42%),functional dyspepsia(20%),inflammatory bowel diseases(20%),esophageal symptoms(10%),and"other"(8%).Demographic variables and disease type did not differentiate between those who did and did not schedule an intake.Mean t-scores for the BSI global score index and the depression,anxiety,and somatization subscales fell below the cutoff for clinical significance(t=63).Treatments were predominantly gut-directed hypnosis(48%)and cognitive behavioral therapy(44%).Average length of treatment was 4 sessions.Among functional gastrointestinal(GI)patients,those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake[t(197)=2.69,P<0.01].CONCLUSION:Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions.
