Mental Disorders Among Frequent Attenders in Primary Care: A Comparison With Routine Attenders
Abstract
Frequent attenders account for a large proportion of primary care (PC) contacts, referrals, and prescriptions. Psychosocial and emotional distress is related to the high use of health services. Few studies have focused on the association between mental disorders assessed using structured interviews and frequent use of PC services.The aim of this study was to determine the factors associated with frequent attendance at primary healthcare units, focusing specifically on mental disorders. A two-phase screening epidemiological study comparing frequent attenders and routine attenders in five primary health care units was designed. Three hundred eighteen frequent attenders and 203 patients who attended the same units on a routine basis were compared. Sociodemographic and clinical data were obtained from statistical records and medical charts. Patients with a total score equal or higher than 7 points on the General Health Questionnaire-28 (GHQ-28) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. All the scores obtained on the GHQ were statistically different in the two populations. Frequency of mental disorders also differed significantly between both groups, with somatoform and affective disorders being the most prevalent ICD-10 categories among frequent attenders. The presence of depressive disorders and somatoform disorders is the most powerful predictive factor for frequent attendance. High comorbidity was found among frequent attenders with somatoform disorder. Frequent attendance at primary healthcare units is associated with depressive and somatoform disorders. Psychiatric comorbidity could be a confounder, particularly because affective and somatoform disorders often overlap in PC patients.
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Somatoform disorders and medically unexplained symptoms are associated with high health care utilization.
“Somatoform disorders [8] and medically unexplained symptoms [9] are associated with high health care utilization”
From One-session cognitive behavior treatment for long-term frequent attenders in primary care: randomized controlled trial (2019) · cites this paper as [8]
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Aragonès, E. (2015) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/j.fmc.2015.02.025 · Cited by 1 · see citing works
- Authors
- Gili, M., Luciano, J. V., Serrano, M. J., Jiménez, R., Bauza, N., & Roca, M.
- Affiliations
- Red de Investigación en Actividades Preventivas y Promoción de la Salud (ES)
- Corresponding author
- Gili, Margalida
- Jiménez, Rafael
- Roca, Miquel
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2011-10
- Volume
- 199
- Issue
- 10
- Pages
- 744-749
- ISSN
- 0022-3018 (ISSN-L)
- OpenAlex
- W2078432832
- Cited by
- 53
- References
- 45
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 4 · 2012: 5
- FWCI
- 5.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- frequent attenders, primary care, mental illness, depressive disorders, somatoform disorders, mood disorders, psychiatric comorbidity, health care utilization, GHQ-28, psychosocial distress
- MeSH terms
- Adult, Aged, Mental Disorders, Female, Humans, Male, Middle Aged, Primary Health Care, Somatoform Disorders, Spain, Comorbidity, Prevalence
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