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High-utilizing Crohn's disease patients under psychosomatic therapy
Hans-Christian Deter1, Jörn von Wietersheim, Günther Jantschek
1Department of Psychosomatics and Psychotherapy, Charité Campus Benjamin Franklin, Berlin, Germany. deter@charite.de
Biopsychosocial Medicine
|October 15, 2008
Summary
Psychological treatment significantly reduced healthcare utilization in high-utilizing Crohn's disease (CD) patients. Depression and disease activity are key factors influencing CD outcomes and healthcare needs.
Area of Science:
- Gastroenterology
- Psychosomatic Medicine
- Health Services Research
Background:
- Limited research exists on healthcare utilization patterns in Crohn's disease (CD).
- The impact of psychological interventions on high healthcare utilizers with CD remains underexplored.
Purpose of the Study:
- To investigate the influence of Crohn's disease course on healthcare utilization (hospital days and sick leave days).
- To examine the characteristics and outcomes of high-utilizing CD patients.
- To evaluate the effect of psychological treatment on high utilizers compared to a control group.
Main Methods:
- A sub-study of a prospective, multi-center investigation involving 87 Crohn's disease patients.
- Collected data on hospital days (HD) and sick leave days (SLD) from German insurance companies.
- Compared high healthcare utilizing patients receiving psychotherapy versus a control group over one year, alongside standardized somatic treatment.
Main Results:
- Disease activity at randomization predicted the clinical course (r2 = 0.28).
- Psychological factors (anxiety, depression, lack of control) predicted health-related quality of life (HRQL).
- High utilizers receiving psychological treatment showed a significant reduction in HD and SLD compared to the control group.
Conclusions:
- Both psychological and somatic factors influence the course of Crohn's disease, with depression being particularly significant.
- Psychological treatment offers a significant benefit in reducing healthcare utilization for high-utilizing CD patients.
- Further research is needed to confirm clinical outcomes in this specific CD subgroup.
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