The psychiatric profile of patients with chronic diseases who do not receive regular medical care.
OBJECTIVE
To assess the relationship between psychiatric disorders and lack of regular medical care in individuals with chronic medical diseases.


METHODS
Nine hundred sixty-three respondents to the household-based Baltimore Epidemiologic Catchment Area (ECA) Follow-Up Study were interviewed in 1981, 1982, and 1993-1996. The main outcome measures were: 1) not receiving regular care from a health professional for an active chronic medical condition in 1981, 2) persistent lack of regular medical care, and 3) leaving regular medical care.


RESULTS
In cross-sectional analyses, having a psychiatric disorder (OR 1.70, 95% CI 1.17-2.48) was associated with not receiving regular medical care. This was mostly due to individuals with phobic disorder (OR 1.57, 95% CI 1.02-2.43). In prospective analyses, depression (RR 2.4, p < 0.04) and alcohol abuse (RR 2.9, p < 0.001) predicted leaving regular medical care one year later. Phobic disorder (RR 2.8, p < 0.001) predicted leaving care thirteen years later.


CONCLUSIONS
Psychiatric disorders appear to place an individual at risk for irregular medical care. Studies of the quality and continuity of care for patients with chronic medical conditions should include measures of common psychiatric conditions.
Cooper-Patrick
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Johns Hopkins University, USA.
Crum
R M
RM
Pratt
L A
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Eaton
W W
WW
Ford
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DE
D000293:Adolescent; D000328:Adult; D000368:Aged; D015142:Baltimore; D002908:Chronic Disease / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology; D012307:Risk Factors; D012803:Sick Role