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Mental health and medical consultation in primary care settings

Published online by Cambridge University Press:  09 July 2009

J. L. Vázquez-Barquero*
Affiliation:
Department of Psychiatry and Medical Psychology, National Hospital Valdecilla, Cantabria Medical School, University of Cantabria, Santander, Spain; General Practice Research Unit, Institute of Psychiatry, London and Academic Subdepartment of Psychological Medicine, North Wales Hospital, Denbigh
G. Wilkinson
Affiliation:
Department of Psychiatry and Medical Psychology, National Hospital Valdecilla, Cantabria Medical School, University of Cantabria, Santander, Spain; General Practice Research Unit, Institute of Psychiatry, London and Academic Subdepartment of Psychological Medicine, North Wales Hospital, Denbigh
P. Williams
Affiliation:
Department of Psychiatry and Medical Psychology, National Hospital Valdecilla, Cantabria Medical School, University of Cantabria, Santander, Spain; General Practice Research Unit, Institute of Psychiatry, London and Academic Subdepartment of Psychological Medicine, North Wales Hospital, Denbigh
J. F. Diez-Manrique
Affiliation:
Department of Psychiatry and Medical Psychology, National Hospital Valdecilla, Cantabria Medical School, University of Cantabria, Santander, Spain; General Practice Research Unit, Institute of Psychiatry, London and Academic Subdepartment of Psychological Medicine, North Wales Hospital, Denbigh
C. Peña
Affiliation:
Department of Psychiatry and Medical Psychology, National Hospital Valdecilla, Cantabria Medical School, University of Cantabria, Santander, Spain; General Practice Research Unit, Institute of Psychiatry, London and Academic Subdepartment of Psychological Medicine, North Wales Hospital, Denbigh
*
1Address for correspondence: Professor J. L. Vázquez-Barquero, Servicio de Psiquiatria, Hospital Nacional Valdecilla, Facultad de Medicina, Santander 39008, Spain.

Synopsis

This paper examines the effect of psychiatric morbidity, as measured by the GHQ-60, on the probability of being in contact with a primary care physician, and the socio-demographic factors which influenced this effect. We found that the presence of psychiatric morbidity emerged as a major determinant of primary care utilization in both sexes, and about one-sixth of consultations in men and one-fifth of consultations in women could be attributed to it. Logistic modelling was used to investigate the joint effect on general practitioner consultation of psychiatric morbidity and seven socio-demographic variables. Sex, age, and psychiatric morbidity exerted independent, but not interactive, effects on consultation.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1990

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References

Aday, L. A. & Andersen, R. (1975). Development of Indices of Access to Medical Care. Health Administration Press: Ann Arbor.Google Scholar
Andersen, A. S. & Laake, P. (1983). A causal model for physician utilization: analysis of Norwegian data. Medical Care 21, 266278.CrossRefGoogle ScholarPubMed
Andersen, A. S. & Laake, P. (1987). A model for physician utilization within 2 weeks. Analysis of Norwegian data. Medical Care 25, 300310.CrossRefGoogle Scholar
Andersen, R. & Newman, J. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Foundation Quarterly 51, 91124.Google ScholarPubMed
Andersen, R., Kravils, J. & Anderson, O. (1975). Equity in Health Services: Empirical Analyses in Social Policy. Ballenger: Cam-bridge, Mass.Google Scholar
Baker, R. J. & Nelder, J. A. (1987). The GLIM System Release 3.77. Royal Statistical Society: London.Google Scholar
Banks, M. H., Beresford, S. A., Morell, D. C., Waller, J. & Watkins, C. J. (1975). Factors influencing demand for primary medical care in women aged 20–44 years: a preliminary report. International Journal of Epidemiology 4, 189195.CrossRefGoogle Scholar
Barsky, A. J., Wyshak, G. & Klerman, G. L. (1986). Medical and psychiatric determinants of outpatient medical utilization. Medical Care 24, 548560.CrossRefGoogle ScholarPubMed
Briscoe, M. E. (1987). Why do people go to the doctor? Sex differences in the correlates of GP consultation. Social Science and Medicine 25, 507513.CrossRefGoogle Scholar
Burvill, P. W. & Knuiman, M. W. (1983). Minor psychiatric morbidity and general practitioner consulting rates. Psychological Medicine 13, 635643.CrossRefGoogle ScholarPubMed
Collins, E. & Klein, R. (1980). Equity and the NHS: self-reported morbidity and access to primary care. British MedicalJournal 281, 11111115.CrossRefGoogle Scholar
Corney, R. & Murray, (1988). The characteristics of high and low attenders at two general practices. Social Psychiatry and Psychiatric Epidemiology 23, 3948.CrossRefGoogle ScholarPubMed
Crombie, D. L. (1984). Social Class and Health Status. Inequality or Difference. Occasional paper No. 25. Royal College of General Practitioners: London.Google ScholarPubMed
Diamond, E. L. & Lilienfeld, A. M. (1962). Effects of errors in classification and diagnosis in various types of epidemiological studies. American Journal of Public Health 52, 11371142.CrossRefGoogle ScholarPubMed
Fink, R. & Shapiro, S. (1977). Patterns of medical care related to mental illness. Journal of Health and Human Behaviour 7, 98105.CrossRefGoogle Scholar
Finlay-Jones, R. & Burvill, P. W. (1978). Contrasting demographic patterns of minor psychiatric morbidity in general practice and the community. Psychological Medicine 8, 455466.CrossRefGoogle ScholarPubMed
Gilbert, G. N. (1981). Modelling Society. An Introduction to Loglinear Analysis for Social Researchers. George Allen & Unwin: London.Google Scholar
Goldberg, D. P. & Huxley, P. (1980). Mental Illness in the Community: The Pathway to Psychiatric Care. Tavistock Press: London.Google Scholar
Goldberg, D. P. & Williams, P. (1988). A User's Guide to the General Health Questionnaire (GHQ). NFER-Nelson: Windsor.Google Scholar
Hand, D. J. (1979). The variance of a prevalence estimate. Un-published research report. Institute of Psychiatry, London.Google Scholar
Hoeper, E. W., Nycz, G. R. & Regier, D. A. (1980). Diagnosis of mental disorders in adults and increased use of health services in four out-patient settings. American Journal of Psychiatry 137, 207212.Google Scholar
Ingham, J. G. & Miller, P. McC. (1983). Self-referral: social and demographic determinants of consulting behavior. Journal of Psychosomatic Research 27, 233239.CrossRefGoogle Scholar
Jones, K. R. & Vischi, T. R. (1979). Impact of alcohol, drug abuse and mental health treatment on medical care utilization: a review of the research literature. Medical Care 17 Suppl. 1.Google ScholarPubMed
Levin, M. L. (1953). The occurrence of lung cancer in man. Acta Unionis International Contra Cancrum 19, 531541.Google Scholar
Marcus, A. & Siegel, J. M. (1982). Sex differences in the use of physician services: a preliminary test of the fixed role hypothesis. Journal of Health and Social Behavior 23, 186196.CrossRefGoogle ScholarPubMed
Mechanic, D. (1962). The concept of illness behavior. Journal of Chronic Disease 15, 189190.CrossRefGoogle ScholarPubMed
Mechanic, D. (1979). Correlates of physician utilization: Why do multivariate studies of physician utilization find trivial psychosocial and organizational effects? Journal of Health and Social Behavior 20, 387396.CrossRefGoogle ScholarPubMed
Tanner, J. L., Cockerham, W. C. & Spaeth, J. L. (1983). Predicting physician utilization. Medical Care 21, 361369.CrossRefGoogle ScholarPubMed
Tarnopolsky, A. & Morton-Williams, J. (1980). Aircraft Noise and the Prevalence of Psychiatric Disorders. Social & Community Planning Research: London.Google Scholar
V´azquez-Barquero, J. L. (1990). Mental health in primary care settings. In The Public Health Impact of Mental Disorder (ed. Goldberg, D. P. and Tantam, J. D.). Hogreve and Huber: New York. (In the press.)Google Scholar
Vázquez-Barquero, J. L., Diez Manrique, J. F., Peña, C., Aldama, J. M., Samaniego, C. & Quintanal, R. G. (1986). Two stage design in a community survey. British Journal of Psychiatry 149, 8897.CrossRefGoogle Scholar
Vázquez-Barquero, J. L., Diez Manrique, J. F., Peña, C., Aldama, J. M., Samaniego, C., Menendez Arango, J. & Mirapeix, C. (1987). A community mental health survey in Cantabria: a general description of morbidity. Psychological Medicine 17, 227241.CrossRefGoogle ScholarPubMed
Vázquez-Barquero, J. L., Peña, C., Diez-Manrique, J. F., Arenal, A., Quintanal, R. G. & Samaniego, C. (1988). The influence of sociocultural factors on the interaction between physical and mental disturbances in a rural community. Social Psychiatry and Psychiatric Epidemiology 23, 195201.CrossRefGoogle Scholar
Waldron, I. (1983). Sex differences in illness incidence, prognosis and mortality: issues and evidence. Social Science and Medicine 17, 11071123.CrossRefGoogle Scholar
Williams, P., Tarnopolsky, A., Hand, D. & Shepherd, M. (1986). Minor psychiatric morbidity and general practice consultation: The West London Survey. Psychological Medicine. Suppl. 9.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wolinsky, F. D. (1978). Assessing the effects of predisposing, enabling, and illness-morbidity characteristics of health service utilization. Journal of Health and Social Behavior 19, 384396.CrossRefGoogle ScholarPubMed