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Perceived health and high consumers of care: a study of mental health problems in a Swedish primary health care district

Published online by Cambridge University Press:  09 July 2009

L. Borgquist*
Affiliation:
Department of Community Health Sciences, Lund University, Dalby; Department of Psychiatry, University Hospital, Lund; and Institute of Economic Research, Lund University, Lund, Sweden
L. Hansson
Affiliation:
Department of Community Health Sciences, Lund University, Dalby; Department of Psychiatry, University Hospital, Lund; and Institute of Economic Research, Lund University, Lund, Sweden
P. Nettelbladt
Affiliation:
Department of Community Health Sciences, Lund University, Dalby; Department of Psychiatry, University Hospital, Lund; and Institute of Economic Research, Lund University, Lund, Sweden
G. Nordström
Affiliation:
Department of Community Health Sciences, Lund University, Dalby; Department of Psychiatry, University Hospital, Lund; and Institute of Economic Research, Lund University, Lund, Sweden
G. Lindelöw
Affiliation:
Department of Community Health Sciences, Lund University, Dalby; Department of Psychiatry, University Hospital, Lund; and Institute of Economic Research, Lund University, Lund, Sweden
*
1Address for correspondence: Dr Lars Borgquist, Vårdcentralen Tåbelund, Solvägen 33, S-241 31 Eslöv, Sweden.

Synopsis

Many patients with mental health problems are treated in primary health care services. They are often multi-users of care. In the present investigation we have studied patients visiting primary health care clinics who have been assessed for mental health problems according to the Hopkins Symptom Check List (HSCL-25). Two quality-of-life instruments (the Nottingham Health Profile and the Mood Adjective Check List) were applied to describe further the perceived health of the sample.

A random sample of 93 patients was chosen out of 388 patients visiting a primary health care clinic in a Swedish health care district during four weeks in January and February 1990, and these patients were followed prospectively during one year. High consumers of health care during the follow-up period scored a poor perceived health. ‘Feeling worthless’, predicted a high number of days of sickness absenteeism. Hidden cases, not detected by the GPs, consumed more resources than those identified by the GPs. The importance of training and educating general practitioners in the early detection of patients with mental health problems is discussed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

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References

Boardman, A. P. (1987). The General Health Questionnaire and the detection of emotional disorder by general practitioners. A replicated study. British Journal of Psychiatry 151, 373381.CrossRefGoogle ScholarPubMed
Borgquist, L., Nilsson, L. T., Lindelöw, G., Wiklund, I. & Thorngren, K. G. (1992). Perceived health in hip-fracture patients: prospective follow-up of 100 patients. Age and Aging 21, 109116.CrossRefGoogle ScholarPubMed
Derogatis, L. R., Lipman, R. S., Rickels, K., Ühlenhuth, E. H. & Covi, L. (1974). The Hopkins symptom check list. A self report symptom inventory. Behavioral Science 19, 115.CrossRefGoogle Scholar
Dimenäs, , Elof, S., Dahlöf, , Carl, G.Jern, S. & Wiklund, I. K. (1990). Defining quality of life in medicine. Scandinavian Journal of Primary Health Care (suppl. 1), 710.Google Scholar
Erlandsson, S. I. (1990). Tinnitus: tolerance or threat? Psychological and psychophysiological perspectives. Ph.D. thesis. University of Gothenburg.Google Scholar
Glass, R. M., Allan, A. T., Ühlenhuth, E. H., Kimball, C. P. & Borinstein, D. I. (1978). Psychiatric screening in a medical clinic. An evaluation of a self-report inventory. Archives of General Psychiatry 35, 11891195.CrossRefGoogle Scholar
Goldberg, D. P. & Blackwell, P. (1970). Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal 2, 439443.CrossRefGoogle Scholar
Goldberg, D. P. & Bridges, K. (1987). Screening for psychiatric illness in general practice: the general practitioner versus the screening questionnaire. Journal of the Royal College of General Practitioners 37, 1518.Google ScholarPubMed
Goldberg, D. P. & Huxley, P. (1980). Mental Illness in the Community. Pathways to Psychiatric Care. Tavistock Publications: London.Google Scholar
Goldberg, D. P., Kay, C. & Thompson, L. (1976 a). Psychiatric morbidity in general practice and in the community. Psychological Medicine 6, 565569.CrossRefGoogle ScholarPubMed
Goldberg, D. P., Rickels, K., Downing, R. & Hesbacher, P. (1976 b). A comparison of two psychiatric screening tests. British Journal of Psychiatry 129, 6167.CrossRefGoogle ScholarPubMed
Hansson, L., Nettelbladt, P. & Borgquist, L. (1990). Patterns of care in patients utilizing both primary health care and psychiatric care in a Swedish health district. Scandinavian Journal of Primary Health Care 8, 173178.CrossRefGoogle Scholar
Hansson, L., Nettelbladt, P., Borgquist, L. & Nordström, G. (1992). Screening for psychiatric illness in primary care. A cross-sectional study in a Swedish health district. (Submitted.)Google Scholar
Hertzman, P. (1983). The economic costs of mental illness in Sweden 1975. Acta Psychiatrica Scandinavica 68, 359367.CrossRefGoogle ScholarPubMed
Hunt, S. M. & Wiklund, I. (1987). Cross-cultural variation in the weighting of health statements: a comparison of English and Swedish valuations. Health Policy 8, 227235.CrossRefGoogle Scholar
Jönsson, B. (1984). Cost of mental illness in Sweden and prospects for economic assessment. In Evaluation of Mental Health Services Programs (ed. Cronholm, B. and von Knorring, L.), pp. 161173. Swedish Medical Research Council: Umeå.Google Scholar
Kebbon, L., Swartling, P. G. & Smedby, B. (1985). Psychiatric symptoms and psychosocial problems in primary health care as seen by doctors. Scandinavian Journal of Primary Health Care 3, 2330.CrossRefGoogle ScholarPubMed
McGuire, T. G. (1991). Measuring the economic costs of schizophrenia. Schizophrenia Bulletin 17, 375388.CrossRefGoogle ScholarPubMed
Marks, J. N., Goldberg, D. P. & Hillier, V. F. (1979). Determinants of the ability of general practitioners to detect psychiatric illness. Psychological Medicine 9, 337353.CrossRefGoogle ScholarPubMed
Nettelbladt, P., Hansson, L., Stefansson, C. G., Borgquist, L. & Nordström, G. (1993). Test characteristics of the Hopkins Check List (HSCL-25) in Sweden, using Present State Examination (PSE) as a caseness criterion. Social Psychiatry and Psychiatric Epidemiology (in the press).CrossRefGoogle Scholar
Siegel, S. (1956). Nonparametric Statistics for the Behavioral Sciences. McGraw-Hill: New York.Google Scholar
Sjöberg, L., Svensson, E. & Persson, L. O. (1979). The measurement of mood. Scandinavian Journal of Psychology 20, 118.CrossRefGoogle ScholarPubMed
Sörensen, T. (1987). Mental helse i Nordkyst (Mental health in Nordkyst). Nordland fylkeskommune, fykeshelsesjefen: Bodö, Norway.Google Scholar
Wiklund, I. (1990). Measuring quality of life in medicine. Scandinavian Journal of Health Care (suppl. 1), 1114.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Description and Classification of Psychiatric Symptoms: an Instruction Manual for the PSE and CATEGO System. Cambridge University Press: London.Google Scholar