Abstract Background inflammatory bowel diseases (IBD) are lifelong conditions challenging the patient not only with respect to somatic complaints but also affecting psychosocial issues. This may lead to the need for additional psychological care. The present study investigated the patients’ subjective need for additional psychological care and indicators for such a need. Methods We performed a cross-sectional multicentre study on Austrian IBD patients who were in routine care at one of the 18 participating IBD centres. The patients were asked to fill in a questionnaire booklet including the ADAPT, a validated questionnaire on the need for psychological care which gives two separate scores (‘ADAPT-IPC’ -need for integrated psychosomatic care, ‘ADAPT-PT’- need for psychotherapy), a validated questionnaire on the use of complementary and alternative medicine (CAM), the SIBDQ, and questions on clinical and sociodemographic data. The primary endpoint was the need for integrated psychosomatic care, psychotherapy or both. Results 1286 patients returned the questionnaire. In total, 29.7% of all patients expressed a need for additional psychological care, 18.6% expressed a need for ADAPT-IPC and 20.2% expressed a need for ADAPT-PT. The multivariable regression analysis revealed the two dominating factors associated with the need for both types of psychological care were the use of CAM and a low SIBDQ-score ≤ 50 (see Table for details). Conclusion About 30% of the Austrian IBD patients expressed a need for integrated psychosomatic therapy a/o psychotherapy. This need was especially associated with reduced quality of life and the use of CAM which may indicate the desire for emphathetic and dedicated care. Further studies will be necessary to clarify if these results can be reproduced in other countries.

Long diagnostic delay is frequent in inflammatory bowel disease and has been described to be associated with an increased risk for intestinal surgery in patients with Crohn’s disease. We sought to investigate the effect of diagnostic delay on the risk of surgery in patients with ulcerative colitis (UC). In a multicentre cohort study adult patients with UC attending 18 Austrian outpatient clinics were recruited between May 2014 and July 2015 to complete a multi-item questionnaire recording medical characteristics including diagnostic delay. Diagnostic delay was defined as the time period from the first symptom onset to diagnosis of UC. Patients without surgery were compared with those who had undergone colectomy. The survey preparation, data capturing, and exploratory data analysis were performed by using EvaSys software and SPSS. 400 patients with UC (192 females) were analysed. The median age at diagnosis was 28 years (IQR 22–41 years) and the median duration of disease was 8 years (IQR 3–16 years). 22 patients (12 females) had undergone colectomy. The median diagnostic delay in UC patients with surgery was significantly shorter than in patients without surgery (median 0.19 years (IQR 0.03–0.28 years) vs. median 0.28 years (IQR 0.19–0.87 years); p < 0.0001). The probability to be diagnosed with UC after first symptom onset is given in Figure 1. Patients with surgery had a longer duration of disease (median 18 years (IQR 10–27 years) vs. median 8 years (IQR 3–15 years; p < 0.0001). Time to diagnosis of UC (years) by colectomy during the further course of the disease In this large Austrian referral centre based UC cohort a short diagnostic delay was associated with a higher risk of colectomy. This might reflect disease severity at the time of disease onset and the subsequent course of disease.

Background: Long diagnostic delay is frequent in inflammatory bowel disease (IBD), especially in Crohn's disease (CD), and may lead to irreversible bowel damage. We sought to investigate the diagnostic delay in a large cohort of Austrian IBD patients. Methods: In a multicentre cohort study adult patients with IBD (Crohn's disease CD, ulcerative colitis UC, inflammatory bowel disease unclassified IBDU) attending 18 Austrian outpatient clinics were recruited between May 2014 and July 2015 to complete a multi-item questionnaire. Medical and socioeconomic chararteristics including diagnostic delay were recorded by that questionnaire. Diagnostic delay was defined as the time period from the first symptom onset to diagnosis of IBD. The survey preparation, data capturing and exploraratory data analysis were performed by using EvaSys software and SPSS. Results: 1218 patients (792 with CD, 405 with UC, 21 with IBDU; 617 women) with a mean age at the time of investigation of 41.5 years (range 18–87 years) and a mean duration of disease of 12.4 years (range 0–49 years) were analyzed. Patients with IBDU were included in the UC group. The median diagnostic delay in patients with CD was 0.53 years (95% confidence interval (CI) 0.45–0.61 years) and in patients with UC/IBDU was 0.28 years (95% CI 0.28–0.36 years) (p<0.001). The probability to be diagnosed with IBD after first symptom onset is given in Figure 1. Figure 1. Time to diagnosis by type of disease. Conclusions: In this large Austrian referral center based IBD cohort the diagnostic delay was significantly longer in CD than in UC/IBDU. The median diagnostic delay was 6 months in CD patients and 3 months in UC/IBDU patients.