Identifying and Supporting At-Risk Vasculitis Patients: Integrating Targeted Mental Health Screening and Psychology Referral into Rheumatology Care

Objectives Mental health concerns are common, yet underrecognized in patients with vasculitis.[1] This pilot study aimed to identify mental health needs by developing a screening tool and referral pathway to improve access to care and quality of life.

Methods Forty-two vasculitis patients consented to participate, 21 completed screening using the Patient Health Questionnaire-2 and -9 (PHQ-2, PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Multidimensional Fatigue Inventory (MFI), Pittsburgh Sleep Quality Index (PSQI), Herth Hope Index (HHI), AAV-PRO, SF-36 and Alcohol Use Disorders Identification Test-Consumption (AUD-C). Disease severity was measured using the Birmingham Vasculitis Activity Score (BVAS) and Vasculitis Damage Index (VDI). Three voluntary sessions with a clinical psychologist were offered. Patient-reported outcomes were assessed at baseline and post-psychologist sessions.

Results Thirteen patients (62%) attended psychology sessions. Five attended 3 sessions, 1 attended 2, and 7 attended 1. Post-sessions, the AAV-PRO indicated improvements in systemic symptoms (mean 38.0 to 26.9), treatment side effects (33.1 to 22.3), social/emotional impact (28.2 to 21.1), and future concerns (30.7 to 22.7). SF-36 scores improved in energy/fatigue (38% to 50%) and sleep quality (PSQI 7.8 to 6.6). PHQ-9 and GAD-7 scores showed minor improvements (PHQ-9: 5.8 to 5.5; GAD-7: 4.15 to 4.38). AUD-C scores decreased from 3.0 to 2.38. Overall, 54% reported improved well-being, 70% perceived mental health benefits and satisfaction with care (mean 9.15/10).

Conclusion Integrating mental health screening and referral is feasible and may improve patient-outcomes. Future research should refine and validate a comprehensive screening tool with interpretation guidance and establish clear referral guidelines.

References [1.] Robson JC. Patient Relat Outcome Meas 2018;9:17-34.