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Psychological Distress as a Predictor of Frequent Attendance in Family Practice

A Cohort Study

Received October 5, 2000; revised April 25, 2001; accepted May 16, 2001. From the Research Unit and Department of General Practice, University of Aarhus, Denmark; Research Unit for Functional Disorders, Aarhus University Hospital, Denmark; Institute for Basic Psychiatric Research, Department of Psychiatric Demography, Psychiatric Hospital in Aarhus, Denmark. Address correspondence to Dr. Vedsted, The Research Unit for General Practice, University of Aarhus, Vennelyst Boulevard 6, DK-8000 Aarhus C, Denmark. E-mail: pv{at}alm.au.dk

In cross-sectional studies, psychological distress has been associated with frequent health care utilization. However, there is a need for prospective studies to confirm these findings. This cohort study evaluated whether psychological distress predicted frequent attendance in family practice. In 1990, 185 consecutive adults who consulted their primary care physician (PCP) about an illness were rated on two psychometric scales (Hopkins Symptom Check List [SCL-8] and Whiteley-7), and their annual number of face-to-face contacts with a family practice was followed until 1996. Frequent attenders (FAs) were defined as the top 10%. A logistic regression analysis showed a significantly increased risk of becoming an FA with an increase of 1 point (odds ratio [OR] 1.17 [1.03–1.33]) on SCL and 1.28 (1.06–1.53) on Whiteley). An association was found between score and number of years as an FA (OR 1.16 [0.99–1.36] for SCL and OR 1.31 [1.05–1.65] for Whiteley). Psychological distress involved an increased risk of future frequent attendance among adult patients consulting family practice in the daytime about an illness.

Key Words: Family Practice • Health Services • Rating Scales

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