Somatization and Health Anxiety as Predictors of Health Care Use
Abstract
Objective To assess whether the number of somatic symptoms and health anxiety are independent predictors of future health care use after adjusting for confounders. Methods In a random sample of the adult UK population, questionnaires assessed the number of somatic symptoms (Somatic Symptom Inventory), health anxiety (Whiteley Index), anxiety/depression (Hospital Anxiety and Depression Scale), the number of physical illnesses and demographic variables. The number of consultations in primary care was obtained from medical records for 1 year before and after questionnaire assessment, and negative binomial regression analyses identified predictors of consultation rate. Results The sample included 961 participants (58.0% response) with complete medical record data for 609 participants. After adjustment for consultation rate in the prior year, the predictors of subsequent consultation rate in primary care were the number of physical illnesses, off work through illness, Whiteley Index (incidence rate ratio [IRR] = 1.22, 95% confidence interval [CI] = 1.09-1.35), and the Whiteley Index-by-Somatic Symptom Inventory interaction term. Reported physical abuse predicted an increased consultation rate in women (IRR = 2.30, 95% CI = 1.08-4.90) but a reduced rate in men (IRR = 0.43, 95% CI = 0.22-0.84), interaction p = 0.003. Conclusions These data raise the possibility that both increased health anxiety and number of bothersome somatic symptoms predict frequent medical consultations. A more…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
The results are representative of FAs in general.
“Although only a low proportion of FAs and NAs responded to the study, there is enough similarity with anonymized record-based studies involving other varied practice samples ( 6 , 8 , 9 , 23 , 24 ) to believe that our results are representative of FAs in general.”
From Clinical characteristics of persistent frequent attenders in primary care: Case-control study (2015) · cites this paper as [8]
Cites
SPINHOVEN, P., ORMEL, J., SLOEKERS, P. P. A., KEMPEN, G. I. J. M., SPECKENS, A. E. M., & HEMERT, A. M. V. (1997) · Psychological Medicine · doi:10.1017/s0033291796004382 · Cited by 2,158 · see citing works
JACOBI, F., WITTCHEN, H.-U., HÖLTING, C., HÖFLER, M., PFISTER, H., MÜLLER, N., & LIEB, R. (2004) · Psychological Medicine · doi:10.1017/s0033291703001399 · Cited by 1,097 · see citing works
Types of dissociation and dissociative types: A taxometric analysis of dissociative experiences.
Waller, N., Putnam, F. W., & Carlson, E. B. (1996) · Psychological Methods · doi:10.1037/1082-989x.1.3.300 · Cited by 894 · see citing works
Efficacy of treatment for somatoform disorders: a review of randomized controlled trials
Kroenke, K. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31815b00c4 · Cited by 450 · see citing works
Smith, G. R. (1986) · Archives of Internal Medicine · doi:10.1001/archinte.146.1.69 · Cited by 384 · see citing works
Resource Utilization of Patients With Hypochondriacal Health Anxiety and Somatization
Barsky, A. J., Ettner, S. L., Horsky, J., & Bates, D. W. (2001) · Medical Care · doi:10.1097/00005650-200107000-00007 · Cited by 309 · see citing works
Speckens, A. E. M., Spinhoven, P., Sloekers, P. P. A., Bolk, J. H., & van Hemert, A. M. (1996) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(95)00561-7 · Cited by 303 · see citing works
Fink, P., Ørnbøl, E., & Christensen, K. S. (2010) · PLoS ONE · doi:10.1371/journal.pone.0009873 · Cited by 227 · see citing works
Medical and psychiatric determinants of outpatient medical utilization
Barsky, A. J., Wyshak, G., & Klerman, G. L. (1986) · Medical Care · doi:10.1097/00005650-198606000-00009 · Cited by 161 · see citing works
Psychotherapies for hypochondriasis
Thomson, A., & Page, L. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006520.pub2 · Cited by 141 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Management of functional somatic syndromes and bodily distress
Henningsen, P., Zipfel, S., Sattel, H., & Creed, F. (2018) · Psychotherapy and Psychosomatics · doi:10.1159/000484413 · Cited by 335 · see citing works
Self-citationRief, W., & Martin, A. (2014) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032813-153745 · Cited by 251 · see citing works
Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis
Löwe, B., Levenson, J., Depping, M., Hüsing, P., Kohlmann, S., Lehmann, M., Shedden-Mora, M., Toussaint, A., Uhlenbusch, N., & Weigel, A. (2022) · Psychological Medicine · doi:10.1017/s0033291721004177 · Cited by 217 · see citing works
Anxiety in Parkinson's disease: identification and management
Chen, J. J., & Marsh, L. (2014) · Therapeutic Advances in Neurological Disorders · doi:10.1177/1756285613495723 · Cited by 161 · see citing works
Functional (psychogenic) dizziness
(2016) · Handbook of clinical neurology · doi:10.1016/b978-0-12-801772-2.00037-0 · Cited by 119 · see citing works
Rask, M. T., Ørnbøl, E., Rosendal, M., & Fink, P. (2017) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000405 · Cited by 81 · see citing works
Clinical characteristics of persistent frequent attenders in primary care: Case-control study
Patel, S., Kai, J., Atha, C., Avery, A., Guo, B., James, M., Malins, S., Sampson, C., Stubley, M., & Morriss, R. (2015) · Family Practice · doi:10.1093/fampra/cmv076 · Cited by 56 · see citing works
Functional Somatic Symptoms and Consultation Patterns in 5- to 7-Year-Olds
Rask, C. U., Ørnbøl, E., Fink, P. K., & Skovgaard, A. M. (2013) · Pediatrics · doi:10.1542/peds.2013-0159 · Cited by 39 · see citing works
Health anxiety is an important driver of healthcare use
Norbye, A. D., Abelsen, B., Førde, O. H., & Ringberg, U. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07529-x · Cited by 38 · see citing works
- Authors
- Tomenson, B., McBeth, J., Chew-Graham, C. A., MacFarlane, G., Davies, I., Jackson, J., Littlewood, A., & Creed, F. H.
- Affiliations
- University of Manchester (GB)
- University of Aberdeen (GB)
- Corresponding author
- Tomenson, Barbara
- ORCID
- Venue
- Psychosomatic Medicine
- Published
- 2012-07
- Volume
- 74
- Issue
- 6
- Pages
- 656-664
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2084912623
- Cited by
- 51
- References
- 10
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 1 · 2016: 9 · 2015: 4 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- Versus Arthritis
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- somatic symptoms, health anxiety, health care utilization, primary care visits, Whiteley Index, physical illness, physical abuse, gender differences, DSM-V, ICD-11, anxiety and depression
- MeSH terms
- Adult, Aged, Anxiety, Child, Child Abuse, Depression, Epidemiologic Methods, Family Practice, Female, United Kingdom, Health Status, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Primary Health Care, Referral and Consultation, Somatoform Disorders, Confounding Factors, Epidemiologic, Sex Distribution, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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
