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Table of Contents
Vol. 77, No. 5, 2008
Issue release date: August 2008
Section title: Regular Article
Psychother Psychosom 2008;77:306–314
(DOI:10.1159/000142523)

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

Ferrari S.a · Galeazzi G.M.a · Mackinnon A.b · Rigatelli M.a
aDepartment of Neuroscience – TCR, University of Modena and Reggio Emilia, Modena, Italy; bCentre for Mental Health Research, Australian National University, Canberra, Australia

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: July 04, 2008
Issue release date: August 2008

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 5

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

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 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.

© 2008 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: July 04, 2008
Issue release date: August 2008

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 5

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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