title: Psychosocial problems in adolescents associated with frequent health care use.
abstract: BACKGROUND
  The prevalence of somatic, mental and behavioural problems increases in puberty. Nevertheless, compared to adults, health service utilization by adolescents, and associated factors such as risky health behaviours, have been poorly explored. In order to improve health care services, there is a need for further research on adolescents frequently using primary health care.
  
  
  OBJECTIVE
  We aimed to investigate adolescents who seek help for health issues, and examine whether particular socio-economic or psychological factors predict frequent primary health care use.
  
  
  METHODS
  Finnish adolescents aged 13-18 years (N = 793) attending comprehensive, upper secondary and vocational schools participated in the study in 2005. Data were collected using a questionnaire that included the Youth Self Report (YSR), as well as questions on the psychosocial background of the adolescents and substance use. Data regarding the frequency of use of health services were gathered from medical records of the local public health care services.
  
  
  RESULTS
  Altogether, 288 in the sample had used primary health care services making a combined total of 1411 health care visits. Female gender associated with frequent primary health care use. Furthermore, a high level of alcohol consumption and mental health symptoms in girls, and increased self-reported somatic complaints in the YSR in boys were associated with frequent primary health care use. Attending upper secondary school was related to less frequent primary health care use.
  
  
  CONCLUSIONS
  Few adolescents frequently use primary health care, but they account for a considerable proportion of all adolescent health care visits. There are higher levels of alcohol consumption, as well as socio-economic, educational and gender differences among adolescent frequent primary health care users.
authors.affiliation: Department of Adolescent Psychiatry, Kuopio University Hospital, PO Box 100, FI-70029 Kuopio, virve.kekkonen@kuh.fi.
authors.forename: Virve K
authors.initials: VK
authors.lastname: Kekkonen
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine and.
authors.forename: Petri
authors.initials: P
authors.lastname: Kivimäki
authors.affiliation: Department of Health and Social Management, University of Eastern Finland, PO Box 1627, FI-70211 Kuopio.
authors.forename: Hannu
authors.initials: H
authors.lastname: Valtonen
authors.affiliation: Department of Adolescent Psychiatry, Kuopio University Hospital, PO Box 100, FI-70029 Kuopio, Department of Psychiatry, Institute of Clinical Medicine and.
authors.forename: Tommi
authors.initials: T
authors.lastname: Tolmunen
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine and Department of Psychiatry, Kuopio University Hospital, PO Box 100, FI-70029 Kuopio.
authors.forename: Soili M
authors.initials: SM
authors.lastname: Lehto
authors.affiliation: Department of Psychiatry, Päijät-Häme Central Hospital, Keskussairaalankatu 7, FI-15850 Lahti and School of Medicine, University of Tampere, FI-33014 University of Tampere, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Hintikka
authors.affiliation: Department of Adolescent Psychiatry, Kuopio University Hospital, PO Box 100, FI-70029 Kuopio, Department of Psychiatry, Institute of Clinical Medicine and.
authors.forename: Eila
authors.initials: E
authors.lastname: Laukkanen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000067697:Adolescent Health; D017677:Age Distribution; D016009:Chi-Square Distribution; D004522:Educational Status; D005260:Female; D005387:Finland / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012309:Risk-Taking; D057566:Self Report; D017678:Sex Distribution; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology
keywords: Adolescent; epidemiology; general practice; general practitioner; primary health care; utilization.