CoChat
Sign Up
Cited by 162Psychosomatic Disorders and Their TreatmentsMental Health Treatment and AccessChronic Disease Management Strategies

The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.

Medical and Psychiatric Determinants of Outpatient Medical Utilization

Barsky, Arthur J., Wyshak, Grace, Klerman, Gerald L.·1986·Medical Care
DOI 10.1097/00005650-198606000-00009
Open this paper in CoChat — free account

Abstract

Ninety-two general medical outpatients were surveyed with an interview, questionnaires, and a medical record review to investigate the relationships among psychiatric disorder (depression and hypochondriasis), somatic symptoms, medical morbidity, and the utilization of ambulatory medical services. Medical utilization correlated with the number of somatic symptoms reported (r = 0.49, P = 0.0001), depressive symptoms (r = 0.34, P = 0.001), and the number of medical diagnoses in the medical record. Somatic symptoms were not significantly correlated with the number of medical diagnoses, but were related to hypochondriacal attitudes (r = 0.52, P = 0.0001) and depression (r = 0.51, P = 0.0001). In stepwise multiple regressions, the number of medical diagnoses accounted for 33% of the variance in medical utilization. Somatic symptoms were the second most powerful predictor, increasing R2 to 0.469. The next best predictors were two hypochondriacal attitudes and the presence of a major psychiatric diagnosis in the medical record. This five-step model explained 56% of the variance. Somatic symptoms are thus powerful determinants of medical utilization, even after controlling for medical morbidity. Depression, disease fear, and bodily preoccupation are also important predictors of utilization. Somatic symptoms are a final common pathway through which emotional disturbance, psychiatric disorder, and organ pathology all express themselves, and which prompt patients to visit doctors.

Overview

Integrity signals

Registry

Crossref · 10.1097/00005650-198606000-00009

Cites

53 of 53 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Flagged first, then by citations

Show all 53 references

Cited by

Sorted by citations

See all 162

Related

See all

Metadata

Authors
Barsky, A. J., Wyshak, G., & Klerman, G. L.
Affiliations
Harvard University (US)
Corresponding author
  • Barsky, Arthur J.
  • Klerman, Gerald L.
Venue
Medical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1986-06
Volume
24
Issue
6
Pages
548-560
ISSN
0025-7079 (ISSN-L)
DOI
10.1097/00005650-198606000-00009
OpenAlex
W1966015549
Cited by
161
References
53
Citations by year
2025: 2 · 2021: 1 · 2017: 2 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 6
FWCI
4.46
Type
journal article
Language
en
Open access
closed
Locations
  • Medical Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
outpatient care, somatic symptoms, depression, health anxiety, medical morbidity, mental illness
MeSH terms
Adult, Mental Disorders, Boston, Cross-Sectional Studies, Depression, Female, Hospital Bed Capacity, 500 and over, Humans, Hypochondriasis, Life Change Events, Male, Middle Aged, Morbidity, Outpatient Clinics, Hospital, Outpatients, Patients, Regression Analysis, Stress, Psychological

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review