title: The relationship of life stressors, mood disorder, and health care utilization in primary care patients referred for integrated behavioral health services.
abstract: Exposure to stressful life events, mood disorder, and health care utilization were evaluated in 102 low-income, primarily minority patients receiving behavioral health and medical services at a safety-net primary care clinic. Exposure to major stressors was far higher in this sample than in the general population, with older patients having lower stress scores. Proportions of patients who met the criteria for clinical depression and anxiety were higher than in normative samples of primary care patients. Stress exposure was higher in the patients who met the criterion for clinical anxiety but was unrelated to clinical depression. Contrary to expectation, anxiety, depression, or stress exposure was not related to service utilization. Latter findings are discussed in terms of the influence of the provision of behavioral health services, the highly skewed distribution of major stressor scores, and the likely greater influence of individual differences in minor stressor exposure on utilization in this population.
authors.affiliation: *Virginia Commonwealth University; and †Virginia Commonwealth University Health System (VCUHS), Richmond, VA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sadock
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Auerbach
authors.forename: Bruce
authors.initials: B
authors.lastname: Rybarczyk
authors.forename: Arpita
authors.initials: A
authors.lastname: Aggarwal
authors.forename: Autumn
authors.initials: A
authors.lastname: Lanoye
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008016:Life Change Events; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D064876:Safety-net Providers / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D014768:Virginia / Q000453:epidemiology; D055815:Young Adult