A225 UPTAKE AND OUTCOMES OF MENTAL HEALTH AND NUTRITION COUNSELLING FOR RECENTLY DIAGNOSED IBD PATIENTS.
Bibliographic record
Abstract
Abstract Background Inflammatory bowel disease (IBD) significantly impacts both physical and mental health, with patients experiencing elevated levels of anxiety and depression. Nutritional management is also crucial, as dietary choices can influence physical symptoms. Despite the importance of integrated mental health and nutrition services, numerous barriers, such as limited awareness and access, contribute to suboptimal engagement among patients with IBD. Aims We sought to assess the uptake of integrated psychologist and dietician services in a clinical setting, and to further understand the mental health and nutrition needs of individuals with IBD. Methods In a pilot study initiated in May 2022, recruiting from an IBD clinic at Manitoba’s provincial tertiary hospital, consecutive individuals ages 16+ with IBD diagnosed within 3 years were invited to enrol. Participants completed baseline screening tools including the DASS-21, PHQ8, GAD7, PROMIS, and SaskIBD (nutrition risk) and were offered appointments with an IBD psychologist, dietitian or both, when flagged through the screening tools. Descriptive data were collected regarding clinical screening, psychological diagnoses and interventions, as well as dietary needs and nutrition counselling provided. Results Of 226 eligible, 101 were enrolled (42% Crohn’s disease), and 64 accepted referral to clinical psychology. Of those, >50% and 36-49% met screening criteria for moderate to severe depression and anxiety, respectively. Median scores (± std dev) for DASS-21 were 14 ±9.6 (depression), 8 ±6.6 (anxiety), and 16 ±7.9 (stress); PHQ8 10 ±5.2; and GAD7 8 ±4.7. At an initial semi-structured diagnostic interview, approximately 50% of patients were confirmed to have a psychological diagnosis, most commonly depression (20.6%), anxiety (31.7%) and insomnia/sleep disorder (15.9%). Median number of psychologist visits was 1 ±4.13 (range 0-19); 44.4% of patients returned for follow-up. Of the 37 patients who were not flagged/declined to proceed with the psychologist, only 4 screened positive (1 moderate depression; 3 moderate-severe anxiety). Almost all participants (n=84) were flagged to see the dietitian, with the main needs relating to types of food to avoid and strategies for weight gain or loss. Of those, 52% screened positive for moderate to severe risk of malnutrition, with a median SaskIBD score of 3 ±2.1. Conclusions In a prospective cohort of recently diagnosed IBD patients, there is a demonstrable need for integrated mental health and dietitian expertise with excellent uptake of these services when easily accessible in an outpatient gastroenterology clinic. Ongoing data are being collected to characterize outcomes of this comprehensive model of care for IBD patients. Funding Agencies CCC
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".