Schmitz Norbert, Kruse Johannes
Clinic for Psychosomatic Medicine and Psychotherapy, Heinrich-Heine-University, Bergische Landstr. 2, H19, 40605 Duesseldorf, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2002 Aug;37(8):380-6. doi: 10.1007/s00127-002-0567-2.
Frequent use of health services has been associated with mental disorders and psychological distress. The present study aimed to determine how mental disorders affect the likelihood of using health services in a nationally representative sample.
The analysis was based on data on 3726 respondents aged 18-65 years from the German National Health Interview and Examination Survey, a nationally representative multistage probability survey conducted from 1997 to 1999. Health care utilization in the previous year was measured by a self-report questionnaire. Psychiatric diagnoses were assessed by a modified version of the Composite International Diagnostic Interview.
The relationship between mental illness and medical service utilization was substantial and significant. Twelve-month prevalence rates for respondents with normal health service use were 10.2 % (affective disorders), 11.9 % (anxiety disorders), 8.9 % (somatoform disorders), and 15.4 % (substance use disorder). In contrast, 12-month prevalence rates for high utilizers were 25.1 % (affective disorders), 29.3 % (anxiety disorders), 22.2 % (somatoform disorders), and 17.1 % (substance use disorder).
High utilizers of health care service should be assessed for common mental disorders. Efforts should be made to increase awareness, recognition, and appropriate early intervention of mental disorders.
频繁使用医疗服务与精神障碍及心理困扰有关。本研究旨在确定在一个具有全国代表性的样本中，精神障碍如何影响使用医疗服务的可能性。
分析基于来自德国国民健康访谈与检查调查的3726名18 - 65岁受访者的数据，该调查是1997年至1999年进行的具有全国代表性的多阶段概率调查。前一年的医疗保健利用情况通过自我报告问卷进行测量。精神疾病诊断通过复合国际诊断访谈的修改版进行评估。
精神疾病与医疗服务利用之间的关系显著且密切。健康服务使用正常的受访者的12个月患病率分别为10.2%（情感障碍）、11.9%（焦虑障碍）、8.9%（躯体形式障碍）和15.4%（物质使用障碍）。相比之下，高使用者的12个月患病率分别为25.1%（情感障碍）、29.3%（焦虑障碍）、22.2%（躯体形式障碍）和17.1%（物质使用障碍）。
应对高医疗服务使用者进行常见精神障碍评估。应努力提高对精神障碍的认识、识别和适当的早期干预。
