title: Are illness perceptions related to future healthcare expenditure in patients with somatoform disorders?
abstract: BACKGROUND
  Somatoform disorders are costly for society in terms of increased healthcare expenditure. Patients' illness perceptions have been found to play a role in somatoform disorders. However, it is unclear whether illness perceptions predict higher health costs in these patients.
  
  
  METHODS
  A total of 1785 primary care patients presenting a new health complaint completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics after the consultation. In a stratified subsample, physician interviewers established diagnoses of DSM-IV somatization and undifferentiated somatoform disorders (n = 144) using the Schedules for Clinical Assessment in Neuropsychiatry. Healthcare expenditure was obtained from Danish health registers for a 2-year follow-up period.
  
  
  RESULTS
  Patients had more negative perceptions of their well-defined physical health problems when they had a co-morbid somatoform disorder. A strong illness identity [β = 0.120, 95% confidence interval (CI) 0.029-0.212, p = 0.012], perceived negative consequences (β = 0.010, 95% CI 0.001-0.019, p = 0.024), a long timeline perspective (β = 0.013, 95% CI 0.005-0.021, p = 0.001), low personal control (β = - 0.009, 95% CI -0.015 to -0.002, p = 0.011) and negative emotional representations (β = 0.009, 95% CI 0.002-0.017, p = 0.020) predicted healthcare expenditure in somatoform disorders.
  
  
  CONCLUSIONS
  The results suggest that illness perceptions play a role in the perpetuation of symptoms in somatoform disorders and predict higher future healthcare expenditure among a subgroup of these patients.
authors: Research Clinic for Functional Disorders,Aarhus University Hospital,Aarhus,Denmark.
authors: L
authors: L
authors: Frostholm
authors: Department of Psychological Medicine,Auckland University,Auckland,New Zealand.
authors: K J
authors: KJ
authors: Petrie
authors: Research Clinic for Functional Disorders,Aarhus University Hospital,Aarhus,Denmark.
authors: E
authors: E
authors: Ornbøl
authors: Research Clinic for Functional Disorders,Aarhus University Hospital,Aarhus,Denmark.
authors: P
authors: P
authors: Fink
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D013001:Somatoform Disorders / Q000191:economics* / Q000523:psychology*; D055815:Young Adult