Is the impact of depressive complaints on the use of general health care services dependent on severity of somatic morbidity?

Full Abstract

OBJECTIVE:
The aim of this study was to examine the effects of depressive complaints and chronic medical illnesses on prospective somatic health care utilization and the possible heterogeneity of the effect of depressive complaints across levels of medical illness severity.

METHODS:
Data from a community-based sample of adults (n=9428) were used, of whom a health survey and claims data, indicating health care use, were available. Assessments of depressive complaints and somatic illnesses were based on self-report. Binomial regression analyses were used to study the expected relations.

RESULTS:
Depressive complaints and somatic morbidity were both positively related to general health care utilization. Somatic morbidity has an attenuating effect on the impact of depressive complaints:
If it becomes more severe, the impact of depressive complaints on utilization is reduced. Depressive complaints are especially related to the use of paramedic services, use of prescription drugs, and consultations of medical specialists.

CONCLUSION:
Depressive complaints predict somatic health care utilization, but somatic morbidity attenuates this relation. Future research on this subject should include interaction effects of depressive complaints and somatic morbidity. Interventions aiming to reduce excess use related to mental distress should be primarily targeted on subjects with mental distress who have no comorbid somatic morbidity.

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Author information

Author/s: Koopmans, Gerrit T (GT); Lamers, Leida M (LM);

Affiliation: Department of Health Policy and Management, Erasmus University Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. g.koopmans(-atsign-)erasmusmc.nl

Journal and publication information

Publication Type: Journal Article

Journal: Journal of psychosomatic research (J Psychosom Res), published in England. (Language: eng)

Reference: 2006-Jul; vol 61 (issue 1) : pp 41-50

Dates: Created 2006/07/03; Completed 2006/12/22; Revised 2007/11/15;

PMID: 16813844, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Aged
Aged, 80 and over
Allied Health Personnel - statistics & numerical data
Chronic Disease - epidemiology; psychology
Community Health Services - utilization
Comorbidity
Depressive Disorder - epidemiology; psychology
Disability Evaluation
Drug Utilization - statistics & numerical data
Female
Health Services Misuse - statistics & numerical data
Health Surveys

Health Surveys
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Netherlands
Prospective Studies
Referral and Consultation - utilization
Severity of Illness Index
Sickness Impact Profile
Somatoform Disorders - epidemiology; psychology
Specialties, Medical - statistics & numerical data
Statistics as Topic
Utilization Review

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