Prospective association of anxiety, depressive, and addictive disorders with high utilization of primary, specialty and emergency medical care

Ford, Julián D.; Trestman, Robert L.; Steinberg, Karen; Tennen, Howard; Allen, Scott

doi:10.1016/j.socscimed.2003.08.017

Cited by 94 publications

(47 citation statements)

References 17 publications

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“…Previous studies have suggested that they may lead to high or excessive use of health care services, especially when combined with medical morbidity [5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

Frequent Attenders in Primary Care: Impact of Medical, Psychiatric and Psychosomatic Diagnoses

Ferrari

Galeazzi

Mackinnon

et al. 2008

Psychother Psychosom

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Background: Anxiety, mild depression and somatization are common in primary care (PC). Several studies have suggested that they may play a role in causing an excessive use of health care services, especially when combined with medical morbidity. The present case-control study explored how psychiatric and psychosomatic diagnoses and perceived quality of life are associated with the phenomenon of frequent attendance. Method: Fifty most frequent attenders (FAs) in a 1-year period at a PC clinic in Italy were compared with 50 randomly selected average frequency attenders at the same clinic. Sociodemographic and medical data were collected from PC files. The SCID-brief version for research and the Structured Interview for Diagnostic Criteria for Use in Psychosomatic Research (DCPR) were administered to both patient groups. Quality of life was also assessed. Results: FA status was associated with being female, older, less well educated, and living with their spouses and/or children. Medical-psychiatric comorbidity was more frequent in the FA group than in the control group. The median number of psychosomatic-DCPR syndromes per patient was 4 among FAs compared to only 1 in controls. Functional somatic symptoms secondary to a psychiatric disorder, type A behavior, irritable mood, and demoralization were significantly associated with being an FA. Perceived quality of life was significantly lower among FAs, although this was no longer significant after adjusting for sociodemographic variables. Conclusions: The present study confirms the association between medical-psychiatric comorbidity and frequent utilization of PC resources. It suggests a role for DCPR criteria in revealing subthreshold psychiatric comorbidity predicting a pattern of frequent attendance.

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“…Previous studies have suggested that they may lead to high or excessive use of health care services, especially when combined with medical morbidity [5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

Frequent Attenders in Primary Care: Impact of Medical, Psychiatric and Psychosomatic Diagnoses

Ferrari

Galeazzi

Mackinnon

et al. 2008

Psychother Psychosom

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show abstract

“…It is known that people with diagnosed psychological diseases have poorer quality of life (Spitzer et al, 1995;The Counselling Versus Antidepressants in Primary Care Study Group, 1999;Lam and Lauder, 2000;Lam et al, 2003), and higher consultation rates (Dowrick et al, 2000;Lam et al, 2003;Ford et al, 2004) than those without. The quality of life and service utilisation rates in those with unrecognised psychological problems, however, have not been well studied and needs to be evaluated in order to establish its clinical relevance and need for intervention.…”

Section: Introductionmentioning

confidence: 99%

Unrecognised psychological problems impair quality of life and increase consultation rates in Chinese elderly patients

Lam

Chin

Lee

et al. 2009

Int J Geriat Psychiatry

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“…"Extreme utilization" was defi ned as that exhibited by the top 10% of participants; previous studies have traditionally used the top 5% as a cut point. 31,32 "Frequent primary care use" was defi ned as more than 4 visits to a primary care physician in the previous 2 months. Other defi nitions have ranged from 15 visits in 3 years 33 to 10 visits per year.…”

Section: Discussionmentioning

confidence: 99%

“…Frequent primary care use was associated with the number of chronic problems, possibly physical symptoms, and the social-spiritual interaction. Previous research linked frequent primary care offi ce to the number of chronic problems, 46 physical symptoms, 33,40 psychological symptoms, 31,33,40,46 poor social support, 46 and religious denomination. 42 King and Pearson 47 found that patients who attended religious services were more likely to report continuity with a regular health care clinician.…”

Section: Extreme Utilizationmentioning

confidence: 99%

Impact of Spiritual Symptoms and Their Interactions on Health Services and Life Satisfaction

Katerndahl¹

2008

The Annals of Family Medicine

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PURPOSE Recent work suggests that the biopsychosocial model should be expanded to include the spiritual dimension as well. The purpose of this study was to assess the independent effects of spiritual symptoms and their interactions with biopsychosocial symptoms on health care utilization, extreme use of services, and life satisfaction among primary care patients. METHODSThree hundred fi fty-three adult waiting room patients at 2 primary care clinics completed the Biopsychosociospiritual Inventory (BioPSSI) as well as measures of life satisfaction and health care use. Hierarchical logistic regression analysis was performed with each outcome to determine whether adding spiritual symptoms and their interaction terms better accounted for outcomes than demographics, functional status, and chronic medical problems alone.RESULTS Spiritual symptoms (alone or in interaction) were associated with 7 of the 10 outcomes and were particularly important to extreme use of health care services and life satisfaction. Among best-fi t models, spiritual symptoms alone were signifi cantly associated with any mental health use (β = 0.694, P ≤.05), fair-poor health status (β = 0.837, P ≤.05), and life lacking meaning (β = 1.214, P ≤.001).CONCLUSIONS This study has shown the relevance of spiritual symptoms and their interactions to understanding health outcomes. Extreme utilization outcomes were related to the number of chronic problems, as well as to the social-spiritual interaction. Satisfaction outcomes were associated with physical and spiritual symptoms. These fi ndings may have important implications for providing comprehensive, outcome-based care, as well as for modeling of research fi ndings.

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Prospective association of anxiety, depressive, and addictive disorders with high utilization of primary, specialty and emergency medical care

Cited by 94 publications

References 17 publications

Frequent Attenders in Primary Care: Impact of Medical, Psychiatric and Psychosomatic Diagnoses

Frequent Attenders in Primary Care: Impact of Medical, Psychiatric and Psychosomatic Diagnoses

Unrecognised psychological problems impair quality of life and increase consultation rates in Chinese elderly patients

Impact of Spiritual Symptoms and Their Interactions on Health Services and Life Satisfaction

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