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

Ferrari, S; Galeazzi, Gian Maria; Mackinnon, Andrew; Rigatelli, M

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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...[Show more]

dc.contributor.authorFerrari, S
dc.contributor.authorGaleazzi, Gian Maria
dc.contributor.authorMackinnon, Andrew
dc.contributor.authorRigatelli, M
dc.date.accessioned2015-12-08T22:44:55Z
dc.date.available2015-12-08T22:44:55Z
dc.identifier.issn0033-3190
dc.identifier.urihttp://hdl.handle.net/1885/37607
dc.description.abstractBackground: 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.
dc.publisherS Karger AG
dc.sourcePsychotherapy and Psychosomatics
dc.subjectKeywords: adult; article; case control study; clinical article; comorbidity; controlled study; demography; educational status; female; human; irritability; Italy; male; mental disease; primary medical care; priority journal; psychiatric diagnosis; psychosomatics; q Diagnostic Criteria for Use in Psychosomatic Research; Frequent attenders; Primary care
dc.titleFrequent attenders in Primary Care: Impact of Medical, Psychiatric and Psychosomatic Diagnoses
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume77
dc.date.issued2008
local.identifier.absfor111714 - Mental Health
local.identifier.ariespublicationU4146231xPUB151
local.type.statusPublished Version
local.contributor.affiliationFerrari, S, Universita di Modena e Reggio Emilia
local.contributor.affiliationGaleazzi, Gian Maria, Universita di Modena e Reggio Emilia (City Univ Mental Health Trust London)
local.contributor.affiliationMackinnon, Andrew, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationRigatelli, M, Universita di Modena e Reggio Emilia
local.bibliographicCitation.issue5
local.bibliographicCitation.startpage306
local.bibliographicCitation.lastpage14
local.identifier.doi10.1159/000142523
dc.date.updated2015-12-08T10:48:59Z
local.identifier.scopusID2-s2.0-46149092551
CollectionsANU Research Publications

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