The relationship between mental disorders and medical service utilization in a representative community sample.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Clinic for Psychosomatic Medicine and Psychotherapy, Heinrich-Heine-University, Bergische Landstr. 2, H19, 40605 Duesseldorf, Germany. schmitzn@uni-duesseldorf.de
Norbert
N
Schmitz
Johannes
J
Kruse
D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology*; D003153:Community Health Services / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D008960:Models, Psychological; D015995:Prevalence; D012044:Regression Analysis; D012306:Risk