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The growing gap between demand and availability of clinical psychology in Paediatric Gastroenterology: a retrospective analysis of clinical routine care.

cam.issuedOnline2020-10-16
dc.contributor.authorWong, Eunice
dc.contributor.authorHeuschkel, Robert
dc.contributor.authorLindsay, Caroline
dc.contributor.authorBenson, Sally
dc.contributor.authorZilbauer, Matthias
dc.contributor.orcidZilbauer, Matthias [0000-0002-7272-0547]
dc.date.accessioned2021-10-18T08:49:59Z
dc.date.available2021-10-18T08:49:59Z
dc.date.issued2021-04
dc.date.submitted2020-07-09
dc.date.updated2021-10-18T08:49:59Z
dc.descriptionFunder: University of Cambridge
dc.description.abstractClinical psychology intervention in paediatric gastroenterology is vital given the biopsychosocial aetiology of paediatric functional gastrointestinal disorders, and the psychological impact of chronic conditions. The aim was to assess the availability and benefit of clinical psychology in paediatric gastroenterology across the UK and Germany. A retrospective assessment of referrals (n = 936 referrals) to clinical psychology was performed at our tertiary paediatric gastroenterology centre between 2010 and 2018. The availability of clinical psychologists and outcome of psychology intervention for children with functional abdominal pain were also assessed. Access to clinical psychology across the UK and Germany was assessed using an online questionnaire. We observed a substantial rise in the number of clinical psychology referrals between 2010 and 2018. Increasing demand was not matched by sufficient increase in availability of clinical psychology, leading to longer waiting times. A major benefit of clinical psychology intervention was highlighted with 95% of patients (n = 20) reporting a significant reduction in symptoms. Of the 12 centres who responded, 11 centres have direct access to clinical psychology with a mean of 13% of patients requiring psychology referrals annually.Conclusion: Despite evidence of its benefit and increasing demand, there is insufficient access to clinical psychological services, highlighting the urgent need to address this important issue. What is known: • The biopsychosocial pathophysiology of functional gastrointestinal disorders involves a disordered brain-gut interaction, which emphasizes the close link between psychological factors and altered gut function. • Psychological intervention, as an adjunct to medical treatment, improves outcomes in paediatric patients with gastrointestinal (GI) disease such as functional gastrointestinal disorders and inflammatory bowel diseases What is new: • There is a rising number of referrals from paediatric gastroenterology to clinical psychology in our centre which is not met by a sufficient increase in the availability of clinical psychologists. Similarly, access to clinical psychological services is lacking in several paediatric gastroenterology centres in the UK and Germany. • Strategic action is required to address this important gap in the care of children suffering from GI diseases.
dc.identifier.doi10.17863/CAM.76990
dc.identifier.eissn1432-1076
dc.identifier.issn0340-6199
dc.identifier.others00431-020-03825-y
dc.identifier.other3825
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/329542
dc.languageen
dc.language.isoeng
dc.publisherSpringer Science and Business Media LLC
dc.publisher.urlhttp://dx.doi.org/10.1007/s00431-020-03825-y
dc.subjectClinical psychology
dc.subjectFunctional abdominal pain
dc.subjectInflammatory bowel disease
dc.subjectPaediatric functional gastrointestinal disease
dc.subjectChild
dc.subjectGastroenterology
dc.subjectGastrointestinal Diseases
dc.subjectGermany
dc.subjectHumans
dc.subjectPsychology, Clinical
dc.subjectRetrospective Studies
dc.titleThe growing gap between demand and availability of clinical psychology in Paediatric Gastroenterology: a retrospective analysis of clinical routine care.
dc.typeOther
dcterms.dateAccepted2020-10-01
prism.endingPage1312
prism.issueIdentifier4
prism.publicationNameEur J Pediatr
prism.startingPage1307
prism.volume180
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1007/s00431-020-03825-y

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