Research indicates a higher risk of somatic problems and cardiovascular and respiratory mortality among patients with non-affective psychotic disorders (NAPD). Data on health care (HC) utilization of this group have revealed ambivalent results pointing at a higher appeal to somatic HC and possible under-consumption.

This study focuses on somatic HC utilization in the Netherlands among patients with NAPD, unipolar depression, anxiety or bipolar disorder, compared to matched controls without psychiatric diagnosis.

To study possible under-consumption associated with NAPD and its correlates.

The HC utilization of 2,392 cases with NAPD registered in the Psychiatric Case Register Middle Netherlands (PCRMN) and above mentioned comparison groups was analyzed by using linked data on prescribed medication, general practitioner (GP) consults and treatment by specialists from insurance company Agis.

The costs for somatic HC among NAPD patients was on average €1621 per year, marginally higher compared to matched controls (€1441, p=0.079). Among patients with depression and anxiety, much greater differences with their matched controls were found (p< 0.05). The percentage of NAPD patients who received somatic treatment by a specialist was lower than that of controls (OR=0.89, P< 0.05), especially at higher age (>60) and longer duration since diagnosis (>5 years) (OR=0.60, P< 0.05). In particular, treatment by a specialist was lower for cardiovascular disorders (OR=0.61) and diabetes (OR=0.37, P< 0.05).

In view of the higher somatic death risk, our data suggest HC under-consumption, which is increasing with a longer illness duration and older age.