Kujanpää Tero S, Jokelainen Jari, Auvinen Juha P, Timonen Markku J
1 Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.
2 Unit of Primary Care, Oulu University Hospital, Oulu, Finland.
Int J Psychiatry Med. 2017 Mar;52(2):147-159. doi: 10.1177/0091217417720894.
Objective Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms. Method This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n = 4) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors. Results Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58-3.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99-1.64), 1.94 (95% CI 1.46-2.58), 2.33 (95% CI 1.65-3.28), and 3.64 (95% CI 2.15-6.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder. Conclusions Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.
目的 广泛性焦虑障碍与更高的躯体共病率、不明原因症状及医疗保健利用率相关。然而，躯体症状在决定医疗保健利用率方面的作用尚不清楚。本研究旨在评估广泛性焦虑障碍症状与躯体症状之间在医疗保健服务频繁就诊方面的关联。方法 本研究采用1966年芬兰北部出生队列46年随访调查资料进行横断面研究。共有5585名队列成员回复了有关医疗保健利用、病史、躯体症状及广泛性焦虑障碍-7筛查工具的问卷。针对广泛性焦虑障碍症状及霍普金斯症状清单-25的所有（n = 4）躯体症状，计算在控制混杂因素情况下医疗保健利用率处于最高十分位数的比值比。结果 经调整后，广泛性焦虑障碍症状导致医疗保健服务频繁就诊的比值比为2.29（95%可信区间1.58 - 3.31），而1、2、3及4种躯体症状导致医疗保健服务频繁就诊的比值比分别为1.28（95%可信区间0.99 - 1.64）、1.94（95%可信区间1.46 - 2.58）、2.33（95%可信区间1.65 - 3.28）及3.64（95%可信区间2.15 - 6.18）。有广泛性焦虑障碍症状的人平均躯体症状数量（1.8个）高于其他队列成员（0.9个）。此外，无躯体症状的人中有1.6%广泛性焦虑障碍检测呈阳性，而有4种躯体症状的人中有22.6%广泛性焦虑障碍检测呈阳性。结论 广泛性焦虑障碍症状和躯体症状均与医疗保健频繁就诊的较高风险相关。
