title: Preventive medical services use among community mental health patients with severe mental illness:the influence of gender and insurance coverage.
abstract: BACKGROUND
  This study examines predictors of reduced preventive health service use in patients with severe mental illness by examining psychiatric diagnoses and demographic factors.
  
  
  METHODS
  Of 387 patients approached in 4 community mental health clinics regarding their preventive health services use from January 2005 to May 2007, 234 (60.5%) were interviewed. Of those participants interviewed, 221 had a DSM-IV-TR diagnosis of (1) primary psychotic disorder (schizophrenia or schizoaffective disorder), (2) bipolar disorder, or (3) recurrent major depressive disorder. Psychiatric disorders and demographic factors that predicted high service utilization were analyzed using analysis of variance and χ² tests.
  
  
  RESULTS
  In the linear predictive model, use of preventive services was not statistically different among the 3 diagnostic groups. Participants with primary psychotic disorder used a similar number of preventive services compared to those with bipolar disorder and major depression. Women used more services than men (P < .01), and individuals with health insurance used more than uninsured participants (P < .001).
  
  
  CONCLUSIONS
  Male gender and not having medical insurance were predictive of lower preventive health service use in this sample of patients with severe mental illness. Further research is needed to replicate these findings and to improve use of preventive health services in people with severe mental illness.
authors.affiliation: Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA. gxiong@ucdavis.edu
authors.forename: Glen L
authors.initials: GL
authors.lastname: Xiong
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Iosif
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bermudes
authors.forename: Robert M
authors.initials: RM
authors.lastname: McCarron
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hales