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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
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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.

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Crossref · 10.1097/00005650-198606000-00009

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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

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