The pediatric inflammatory bowel disease INTERMED: A new clinical tool to assess psychosocial needs

The adult INTERMED is used to determine case complexity and psychosocial needs. We developed and validated a pediatric version of the INTERMED for children and adolescents with inflammatory bowel disease (IBD) and assessed its utility in predicting healthcare utilization. We performed a cross-sectio...

Full description

Saved in:
Bibliographic Details
Published in:Journal of psychosomatic research 2019-04, Vol.119, p.26-33
Main Authors: Cohen, Janice S., Lyons, John S., Benchimol, Eric I., Carman, Nicholas, Guertin, Camille, Mack, David R.
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Anxiety
Assessors
Biopsychosocial screening
Child
Children
Cognitive ability
Complexity
Crohn's disease
Cross-Sectional Studies
Family relations
Female
Health care
Help seeking behavior
Humans
Inflammatory bowel disease
Inflammatory bowel diseases
Inflammatory Bowel Diseases - psychology
Integrated care
Interdisciplinary aspects
Internalization
Internalizing disorders
Intestine
Male
Mass Screening - methods
Mental depression
Mental disorders
Mental health
Pediatrics
Predictive validity
Psychosocial factors
Reliability
Severity
Social behavior
Social problems
Ulcerative colitis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The adult INTERMED is used to determine case complexity and psychosocial needs. We developed and validated a pediatric version of the INTERMED for children and adolescents with inflammatory bowel disease (IBD) and assessed its utility in predicting healthcare utilization. We performed a cross-sectional study of children (aged 8–17 y) with IBD (n = 148) and their parents, seen in a hospital-based clinic. Subjects completed semi-structured interviews that were scored on the 34 pIBD-INTERMED items. To assess inter-rater reliability, 40 interviews were videotaped and scored by a second assessor. Convergent and predictive validity were assessed by examining the relation of the pIBD-INTERMED to standardized measures of psychological, social, and family functioning, disease activity, and healthcare utilization. Correlational analyses supported the validity of all five pIBD-INTERMED domains with very good inter-rater reliability (median r = 0.87) and internal consistency (α = 0.91) for the total complexity index. Ratings of 2–3 on the pIBD-INTERMED “mental health/cognitive threat” item were associated with greater odds of behavior and social problems (CBCL-Internalizing scale OR = 7.27, 95% CI 2.17–24.36); CBCL-Externalizing scale OR = 24.79, 95% CI 5.00–122.84), depression (Children's Depression Inventory OR = 8.52, 95% CI 1.70–43.02) and anxiety (Multidimensional Anxiety for Children OR = 11.57, 95% CI 3.00–45.37). The pIBD-INTERMED complexity index added significantly to the prediction of healthcare utilization, beyond the contribution of disease severity. The pIBD-INTERMED is a reliable and valid tool for identifying psychosocial risks and needs of children with IBD. It can be used to guide planning of individualized care and enhance interdisciplinary pediatric IBD care. •A pediatric (pIBD) INTERMED with Crohn's disease or ulcerative colitis was developed as a simple, reliable and valid tool•It can proactively and efficiently identify patient's psychological, social, family/caregiver and health system needs•It can be used to enhance decision making in planning the intensity of psychosocial intervention for pediatric IBD care
ISSN:0022-3999
1879-1360
DOI:10.1016/j.jpsychores.2019.02.002