Specific effects of depression, panic, and somatic symptoms on illness behavior.
OBJECTIVE
In terms of restricted financial resources, the contribution of mental disorders to health care use and illness behavior is highly relevant. However, the specific contributions of panic disorder, depression, and somatic complaints to illness behavior in unselected samples is unclear.


METHODS
A representative sample of 2507 inhabitants of Germany was selected and grouped into people with panic disorder (30), somatic syndrome (102), major depression (24), depressive syndrome (77), and controls (2269). Assessment instruments were the complete version of the Patient Health Questionnaire (PHQ), the Scale for the Assessment of Illness Behavior (SAIB) as well as measures of health care use.


RESULTS
Although all clinical groups showed increased illness behavior, their impact was independent and specific. Subjects fulfilling the criteria of panic disorder showed the highest scores for illness behavior and health care use. People with mental disorders showed a greater increase in visits to general practitioners and medical specialists than to psychiatrists or psychologists. Regression analysis revealed that somatic complaints and depression have independent associations with illness behavior and health care use.


CONCLUSIONS
Different mental and psychosomatic disorders contribute independently to health care use and other aspects of illness behavior.
Rief
Winfried
W
Department of Psychology, University of Marburg, Marburg, Germany. rief@staff.uni-marburg.de
Martin
Alexandra
A
Klaiberg
Antje
A
Brähler
Elmar
E
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003863:Depression / Q000523:psychology*; D003865:Major Depressive Disorder / Q000523:psychology*; D004194:Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D013001:Somatoform Disorders / Q000523:psychology*