Health anxiety is an important driver of healthcare use
Open accessAbstract
Background: Healthcare use is increasing, and health anxiety (HA) is recognized as an important associated factor. Previous research on the association between HA and healthcare use has mostly explored HA as a dichotomous construct, which contrasts the understanding of HA as a continuous construct, and compared healthcare use to non-use. There is a need for studies that examine the association between healthcare use and the continuum of HA in a general population. Aim: To explore the association between HA and primary, somatic specialist and mental specialist healthcare use and any differences in the association by level of healthcare use. Methods: This study used cross-sectional data from the seventh Tromsø study. Eighteen thousand nine hundred sixty-seven participants aged 40 years or older self-reported their primary, somatic specialist and mental specialist healthcare use over the past 12 months. Each health service was categorized into 5 groups according to the level of use. The Whiteley Index-6 (WI-6) was used to measure HA on a 5-point Likert scale, with a total score range of 0–24. Analyses were conducted using unconstrained continuation-ratio logistic regression, in which each level of healthcare use was compared with all lower levels. Morbidity, demographics and social variables were included as confounders. Results: HA was positively associated with increased utilization of primary, somatic specialist and mental specialist healthcare. Adjusting for confounders, including physical and mental morbidity, did not alter the significant association. For primary and somatic specialist healthcare, each one-point increase in WI-6 score yielded a progressively increased odds ratio (OR) of a higher level of use compared to all lower levels. The ORs ranged from 1.06 to 1.15 and 1.05 to 1.14 for primary and somatic specialist healthcare, respectively. For mental specialist healthcare use, the OR was more constant across levels of use, ranging between 1.06 and 1.08. Conclusions: In an adult general population, HA, as a continuous construct, was significantly and positively associated with primary, somatic specialist and mental healthcare use. A small increase in HA was associated with progressively increased healthcare use across the three health services, indicating that the impact of HA is more prominent with higher healthcare use.
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Shortened versions of the Health Anxiety Inventory and Whitley Index 6 have been developed and widely used in clinical settings due to their practicality and brief nature.
“A shortened version of the Health Anxiety Inventory [66] and Whitley Index 6 [68] have been developed and widely used in clinical settings due to their practicality and brief nature [69, 70].”
From Illness Anxiety Disorder: A Review of the Current Research and Future Directions (2024) · cites this paper as [70]
The Methods (Variables; page unavailable) describe the six questions in the WI-6, and the paper uses it to measure health anxiety in a population survey. The cited paper does not establish that the WI-6 or a shortened Health Anxiety Inventory is widely used in clinical settings, or that practicality and brevity explain such use. (LLM, conf=0.82)
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- Authors
- Norbye, A. D., Abelsen, B., Førde, O. H., & Ringberg, U.
- Affiliations
- UiT The Arctic University of Norway (NO)
- Corresponding author
- Norbye, Anja Davis
- Venue
- BMC Health Services Research
- Published
- 2022-02-02
- Volume
- 22
- Issue
- 1
- Pages
- 138-138
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC8812228
- OpenAlex
- W4210333414
- Cited by
- 38
- References
- 43
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 11 · 2023: 8 · 2022: 6
- FWCI
- 4.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- UiT The Arctic University of Norway
- 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
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- health anxiety, health care utilization, primary care utilization, Whiteley Index, psychiatric morbidity, physical morbidity, general adult population
- MeSH terms
- Adult, Anxiety, Anxiety Disorders, Cross-Sectional Studies, Delivery of Health Care, Humans, Self Report
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