P0304An Inflammatory Bowel Disease clinic with integrated mental health screening results in more referrals and greater follow-up to the psychogastroenterology service

Abstract Background Current guidelines recommend mental health (MH) screening in patients (pts) with inflammatory bowel disease (IBD) to identify and provide resources for comorbid MH conditions.1-3 Some IBD clinics are now integrating psychogastroenterology (gastropsych) services to address pts’ MH needs. The association between routine screening for depression and anxiety in IBD clinics and successful uptake to a gastropsych service is unknown. Methods Our tertiary IBD center of multiple IBD specialist providers has piloted in a single clinic the integrated screening for depression and anxiety. In routine outpatient clinic visits, pts are screened using the Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder-7 scale (GAD-7). We retrospectively reviewed adult pts with IBD who were referred to our institution’s gastropsych service and compared those identified during the integrated clinic with those who were referred from clinics that have not integrated MH screening. Completion of MH screening, gastropsych evaluation, and return gastropsych visits were documented, and demographics and disease characteristics were collected. Pearson’s Chi-Square Test of Independence was used to examine the association between MH screening and engagement with our institution’s gastropsych service. Results 155 pts with IBD were referred to our institution’s gastropsych service between March 2023 and June 2025 by 22 providers (10 gastroenterologists, 10 advanced practice providers, 1 dietician, 1 colorectal surgeon). The largest number of referrals (N = 34, 22%) were referred from the clinic/provider piloting the integration of MH screening. In addition, these 34 pts (19 (56%) Crohn’s, 22 (65%) female, 24 (71%) White, median age 33.5 (IQR 28-44), median PHQ-9 5.5, median GAD-7 6) were significantly more likely to schedule and complete an initial gastropsych evaluation (74% vs. 51%, p = 0.021) and slightly more likely to engage in one or more return visits (92% vs. 89%, median 5 visits, range 1-35) (p = 0.648) compared to pts referred from other clinics/providers (Fig. 1). Though not statistically significant, a greater proportion of pts who were female, had a history of anxiety, and did not have symptomatic IBD completed their gastropsych evaluation and followed up with at least one additional gastropsych visit. Conclusion Integrated MH screening in an IBD clinic identifies more pts for referral to gastropsych, and these pts are also more likely to continue their gastropsych follow-up. This may represent the implicit message communicated by integrated screening that MH in people with IBD is an important part of their care. We are expanding our integrated program to the other clinics to further test this hypothesis. References: 1. Gordon H, Burisch J, Ellul P, Karmiris K, Katsanos K, Allocca M, Bamias G, Barreiro-de Acosta M, Braithwaite T, Greuter T, Harwood C, Juillerat P, Lobaton T, Müller-Ladner U, Noor N, Pellino G, Savarino E, Schramm C, Soriano A, Michael Stein J, Uzzan M, van Rheenen PF, Vavricka SR, Vecchi M, Zuily S, Kucharzik T. ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease. J Crohns Colitis. 2024;18(1):1-37. 2. Rubin DT, Ananthakrishnan AN, Siegel CA, Barnes EL, Long MD. ACG Clinical Guideline Update: Ulcerative Colitis in Adults. Am J Gastroenterol. 2025;120(6):1187-1224. 3. Lichtenstein GR, Loftus EV, Afzali A, Long MD, Barnes EL, Isaacs KL, Ha CY. ACG Clinical Guideline: Management of Crohn’s Disease in Adults. Am J Gastroenterol. 2025;120(6):1225-1264. Conflict of interest: Schmaus, Jennifer A.: No conflict of interest Mcdermott, Alexandra: No conflict of interest Bedell, Alyse R.: Grant support from Pfizer Light, Sophia W.: No conflict of interest Rubin, David T.: Grant support from Pfizer and Takeda and has served as a consultant for Abbvie, Abivax SA, Altrubio, Athos Therapeutics, Inc, Bristol-Myers Squibb, Celltrion, Connect BioPharma, Eli Lilly & Co., Genentech (Roche) Inc., Iterative Health, Janssen Pharmaceuticals, Johnson & Johnson, Merck & Co., Mirador, Odyssey Therapeutics, Pfizer, Sanofi, Spyre, Takeda Pharmaceuticals, Vedanta Biosciences, and Ventyx. Board of Directors: Cornerstones Health (non-profit), iUSCAN (non-profit).