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 to medical morbidity. The present case-control study explored how psychiatric and psychosomatic diagnoses and perceived quality of life are associated to the phenomenon of frequent attendance.Methods: The 50 most frequent attenders (FAs) in a one-year period at a PC clinic in Italy were compared to 50 randomly selected average frequency attenders at the same clinic. Socio-demographic 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 spouse 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 behaviour, 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 socio-demographic 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 sub-threshold psychiatric comorbidity predicting a pattern of frequent attendance.

Frequent attenders in primary care: impact of medical, psychiatric and psychosomatic diagnoses / Ferrari, Silvia; Galeazzi, Gian Maria; Mackinnon, Andrew; Rigatelli, Marco. - In: PSYCHOTHERAPY AND PSYCHOSOMATICS. - ISSN 0033-3190. - STAMPA. - 77:5(2008), pp. 306-314. [10.1159/000142523]

Frequent attenders in primary care: impact of medical, psychiatric and psychosomatic diagnoses

FERRARI, Silvia;GALEAZZI, Gian Maria;RIGATELLI, Marco
2008

Abstract

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 to medical morbidity. The present case-control study explored how psychiatric and psychosomatic diagnoses and perceived quality of life are associated to the phenomenon of frequent attendance.Methods: The 50 most frequent attenders (FAs) in a one-year period at a PC clinic in Italy were compared to 50 randomly selected average frequency attenders at the same clinic. Socio-demographic 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 spouse 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 behaviour, 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 socio-demographic 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 sub-threshold psychiatric comorbidity predicting a pattern of frequent attendance.
2008
77
5
306
314
Frequent attenders in primary care: impact of medical, psychiatric and psychosomatic diagnoses / Ferrari, Silvia; Galeazzi, Gian Maria; Mackinnon, Andrew; Rigatelli, Marco. - In: PSYCHOTHERAPY AND PSYCHOSOMATICS. - ISSN 0033-3190. - STAMPA. - 77:5(2008), pp. 306-314. [10.1159/000142523]
Ferrari, Silvia; Galeazzi, Gian Maria; Mackinnon, Andrew; Rigatelli, Marco
File in questo prodotto:
File Dimensione Formato  
FA.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 220.66 kB
Formato Adobe PDF
220.66 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/715846
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 65
  • ???jsp.display-item.citation.isi??? 57
social impact