title: Schizophrenia and contact with health and social services: a Nordic multi-centre study.
abstract: BACKGROUND
  In a Nordic multi-centre study investigating the life and care situation of persons with schizophrenia living in the community, factors explaining use of health and social services were examined.
  
  
  METHODS
  Four hundred and eighteen individuals with schizophrenia from 10 sites were interviewed about their contact with different services (support functions within and outside the mental health services, general practitioners (GPs), physicians in the mental health, psychotherapy, day-care and inpatient treatment), psychopathology, social network and needs for care.
  
  
  RESULTS
  Physicians and support contacts within the mental health system were most used and GPs and psychotherapy least. Three groups of variables were stabile predictors of contact: rural-urban differences, diagnoses (hebephrenic schizophrenia associated with less contact with physicians in the mental services and more with GPs) and health needs as experienced by the patients. No differences between the centres with regard to total service use were found, but the patterns of contact reflected urban-rural variance. A low number of health needs predicted contact with physicians within the mental health services, whereas a high number of such needs was related to contact with GPs and support functions within the mental health services. Social relations exhibited the highest number of unmet needs.
  
  
  CONCLUSIONS
  Contact with physicians working in the mental health services was much more common than contact with GPs. Based on a broad spectre of demographic, clinical and network variables, it was not possible to find models that explained substantial parts of the variance of service use. Patterns of contact were different in rural, town and city-surroundings, and with the exception of psychotherapy, the rural pattern was characterized by use of less specialized services. The importance of health needs and diagnosis as predictors of contact illustrate the profound and lasting effects on health of having a diagnosis of schizophrenia.
authors.affiliation: Nordlandssykehuset, Bodø, Norway. knut.soergaard@nlsh.no
authors.forename: Knut W
authors.initials: KW
authors.lastname: Sørgaard
authors.forename: Mikael
authors.initials: M
authors.lastname: Sandlund
authors.forename: Jyrki
authors.initials: J
authors.lastname: Heikkilä
authors.forename: Lars
authors.initials: L
authors.lastname: Hansson
authors.forename: Hanne R
authors.initials: HR
authors.lastname: Vinding
authors.forename: Olafur
authors.initials: O
authors.lastname: Bjarnason
authors.forename: Anita
authors.initials: A
authors.lastname: Bengtsson-Tops
authors.forename: Lars
authors.initials: L
authors.lastname: Merinder
authors.forename: Lise-Lotte
authors.initials: LL
authors.lastname: Nilsson
authors.forename: Thomas
authors.initials: T
authors.lastname: Middelboe
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012424:Rural Population; D012537:Scandinavian and Nordic Countries; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012949:Social Work, Psychiatric / Q000706:statistics & numerical data*; D014505:Urban Population