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Multicenter Study
. 2021 Feb;9(1):72-81.
doi: 10.1177/2050640620946874. Epub 2021 Feb 18.

Use of complementary and alternative medicine and low quality of life associate with the need for psychological and psychotherapeutic interventions in inflammatory bowel disease

Maximilian Kutschera #  1 , Thomas Waldhör #  2 , Hans Peter Gröchenig  3 , Thomas Haas  4 , Heimo Wenzl  5 , Pius Steiner  6 , Robert Koch  7 , Thomas Feichtenschlager  8 , Gerald Eckhardt  9 , Andreas Mayer  10 , Andreas Kirchgatterer  11 , Othmar Ludwiczek  12 , Reingard Platzer  13 , Pavol Papay  14 , Johanna Gartner  15 , Harry Fuchssteiner  16 , Paul-Gerhard Peters  17 , Gerhard Reicht  18 , Gabriele Moser  1 , Clemens Dejaco  1 , Harald Vogelsang  1 , Christian Primas  1 , Gottfried Novacek #  1 , Wolfgang Miehsler #  19 ; Austrian IBD Study Group
Affiliations
Multicenter Study

Use of complementary and alternative medicine and low quality of life associate with the need for psychological and psychotherapeutic interventions in inflammatory bowel disease

Maximilian Kutschera et al. United European Gastroenterol J. 2021 Feb.

Abstract

Introduction: Patients with inflammatory bowel disease (IBD) suffer from various symptoms, impairing their quality of life and often affecting psychosocial issues. This may lead to the need for additional psychological care. This study investigated patients' subjective need for integrated psychosomatic support and psychotherapy and indicators for it.

Materials and methods: This is a cross-sectional multicentre study in Austrian IBD patients who were in routine care at 18 IBD outpatient clinics. Patients filled in an anonymous, validated questionnaire (Assessment of the Demand for Additional Psychological Treatment Questionnaire [ADAPT]) assessing the need for psychological care. The ADAPT gives two separate scores: the need for integrated psychosomatic support and for psychotherapy. In addition, health-related quality of life and the use of complementary and alternative medicine as well as clinical and socio-demographic variables were queried. Multivariable regression analysis was performed to estimate the effect of the previously mentioned variables on the need for additional psychological care.

Results: Of 1286 patients, 29.7% expressed a need for additional psychological care, 19.6% expressed a need for integrated psychosomatic support and 20.2% expressed a need for psychotherapy. In the multivariable analysis, the two strongest indicators for the need for both types of psychological care were the use of complementary and alternative medicine (for integrated psychosomatic support: odds ratio = 1.64, 95% confidence interval 1.13-2.39, p = 0.010; for psychotherapy: odds ratio = 1.74, 95% confidence interval 1.20-2.53, p = 0.004), and a low health-related quality of life score (for integrated psychosomatic support: odds ratio = 0.95, 95% confidence interval 0.94-0.96, p < 0.001; for psychotherapy: odds ratio = 0.96, 95% confidence interval 0.94-0.97, p < 0.001).

Discussion: About 30% of the Austrian IBD patients expressed a need for integrated psychosomatic support and/or psychotherapy. The most important indicators for this need were the use of complementary and alternative medicine and low quality of life.

Keywords: IBD; crohn's disease; gastroenterology; inflammatory bowel disease; ulcerative colitis.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Thomas Haas has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Janssen, Atro Pharma and Sandoz. Andreas Mayer served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Astro Pharma, Janssen. Pius Steiner has served as a speaker/consultant/advisory board member for Abbvie, MSD, Janssen, Pfizer and Falk. Harry Fuchssteiner has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Janssen and Astro Pharma. Gerald Eckhardt has served as a speaker/consultant/advisory board member for Abbie, MSD, Takeda, Janssen and Astro Pharma. Gerhard Reicht has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Janssen and Astro Pharma. Pavol Papay has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Pfizer, Janssen and Dr. Falk Pharma. Johanna Gartner has served as advisory board member for Merck/Janssen. Reingard Platzer has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Janssen and Astro Pharma. Robert Koch has served as a speaker/consultant/advisory board member for Abbvie, Astro Pharma, Hospira, Janssen, Merck, MSD, Pfizer, Sandoz and Takeda. Thomas Feichtenschlager has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Pfizer and Janssen. Paul‐Gerhard Peters has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Pfizer, Janssen and Roche Pharma. Gabriele Moser has been on the advisory boards of Allergan and Almirall, she has received grants to the Medical University of Vienna by Abbvie, Vifor, Almirall, Merck, Falk, Bayer, Yakult, Sanova, Danone, Emonta and Montavit and she has been on the speakers bureaus for Falk, Peri Consulting, Henrich Communication, Milton Erickson Institut Austria, Wirtschaftskammer Austria and Gebro. Clemens Dejaco has served as a speaker/consultant/advisory board member for Abbvie, Astro Pharma, Bayer, Falk Pharma GmbH, Janssen, MSD, Pfizer, Takeda and Vifor. Christian Primas has served as a speaker/consultant/advisory board member for Abbvie, SD, Takeda, Janssen, Merck, Ferring, Astro Pharma. Harald Vogelsang has received a consultant and/or lecture fee from Abbvie, Amgen, Astro, Bristol‐Myers Squibb, Falk, Ferring, Gilead, Janssen, MSD, Pfizer and Takeda. Gottfried Novacek has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Janssen, Sandoz, Pfizer, Astro Pharma, Falk Pharma GmbH, Ferring and Vifor. Wolfgang Miehsler has served as a speaker/consultant/advisory board member for Abbvie, MSD, Takeda, Janssen, Sandoz, Falk Pharma GmbH and Ferring. The other authors have no conflicts of interest to declare.

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