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Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study.

https://arctichealth.org/en/permalink/ahliterature9135
Source
Psychol Med. 2005 Aug;35(8):1175-84
Publication Type
Article
Date
Aug-2005
Author
Tomas Toft
Per Fink
Eva Oernboel
Kaj Christensen
Lisbeth Frostholm
Frede Olesen
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark. tomas.toft@ouh.fyns-amt.dk
Source
Psychol Med. 2005 Aug;35(8):1175-84
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - diagnosis - epidemiology
Anxiety Disorders - diagnosis - epidemiology
Comorbidity
Female
Humans
Hypochondriasis - diagnosis - epidemiology
International Classification of Diseases
Male
Mental Disorders - diagnosis - epidemiology
Prevalence
Primary Health Care
Research Support, Non-U.S. Gov't
Somatoform Disorders - diagnosis - epidemiology
Abstract
BACKGROUND: Prevalence and co-occurrence of mental disorders is high among patients consulting their family general practitioner (GP) for a new health problem, but data on diagnostics and socio-demographics are sketchy. METHOD: A cross-sectional two-phase epidemiological study. A total of 1785 consecutive patients with new complaints, aged 18-65 years, consulting 28 family practices during March-April 2000 in Aarhus County, Denmark were screened, in the waiting room, for mental and somatic symptoms with SCL-8 and SCL-Somatization questionnaires, for illness worry with Whitely-7 and for alcohol dependency with CAGE. In a stratified random sample of 701 patients, physician interviewers established ICD-10 diagnoses using the SCAN interview. Prevalence was calculated using weighted logistic regression, thus correcting for sample skewness. RESULTS: Half of the patients fulfilled criteria for an ICD-10 mental disorders and a third of these for more than one group of disorders. Women had higher prevalence of somatization disorder and overall mental disorders than men. Men had higher prevalence of alcohol abuse and hypochondriasis than women. Psychiatric morbidity tended to increase with age. Prevalence of somatoform disorders was 35.9% (95% CI 30.4-41.9), anxiety disorders 164% (95% CI 12.7-20.9), mood disorders 13.5% (95% CI 11.1-16.3), organic mental disorders 3.1% (95% CI 1.6-5.7) and alcohol abuse 2.2% (95% CI 1.5-3.1). Co-morbidities between these groups were highest for anxiety disorders, where 89% also had another mental diagnosis, and lowest for somatoform disorders with 39%. CONCLUSIONS: ICD-10 mental disorders are very prevalent in primary care and there is a high co-occurrence between most disorders. Somatoform disorders, however, more often than not exist without other mental disorders.
PubMed ID
16116943 View in PubMed
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The patients' illness perceptions and the use of primary health care.

https://arctichealth.org/en/permalink/ahliterature70485
Source
Psychosom Med. 2005 Nov-Dec;67(6):997-1005
Publication Type
Article
Author
Lisbeth Frostholm
Per Fink
Kaj S Christensen
Tomas Toft
Eva Oernboel
Frede Olesen
John Weinman
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. frost@as.aaa.dk
Source
Psychosom Med. 2005 Nov-Dec;67(6):997-1005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude to Health
Chronic Disease - epidemiology
Comparative Study
Denmark - epidemiology
Female
Follow-Up Studies
Health status
Humans
Life Style
Linear Models
Male
Middle Aged
Patient Acceptance of Health Care
Patients - psychology - statistics & numerical data
Personality Inventory
Primary Health Care - utilization
Questionnaires
Research Support, Non-U.S. Gov't
Sick Role
Somatoform Disorders - diagnosis - epidemiology - psychology
Stress, Psychological - epidemiology - psychology
Abstract
OBJECTIVE: To investigate if primary care patients' perceptions of a current health problem were associated with use of health care. METHOD: One thousand seven hundred eighty-five patients presenting a new health problem to 1 of 38 physicians from 28 general practices in Aarhus County, Denmark. Patients completed a questionnaire on their illness perceptions and emotional distress before the consultation. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Register data on primary health care utilization 3 years before and 2 years after baseline were obtained. Odds ratios were estimated to examine associations between previous health care use and illness perceptions. Linear regression analysis was performed to examine if illness perceptions predicted later health care use. RESULTS: Previous use: Higher use was associated with psychosocial, stress, and lifestyle attributions. Accident/chance attributions were associated with higher use for patients with a chronic disorder but with lower use for patients without a chronic disorder. A strong illness identity (number of self-reported symptoms), illness worry, a long timeline perspective, a belief that the symptoms would have serious consequences, and all emotional distress variables were associated with higher use. Use during follow-up: Infection/lowered immunity attributions were associated with higher use for patients with a chronic disorder, whereas psychosocial and lifestyle attributions were associated with higher use for all patients. Illness worry and all emotional distress variables predicted higher health care use. A strong illness identity, a long timeline perspective, a belief in serious consequences, and stress and accident/chance attributions were among the strongest predictors of health care use in a multivariate model including all variables. CONCLUSIONS: Patients' perceptions of a current health problem are associated with health care use and may offer an obvious starting point for a biopsychosocial approach in primary care.
PubMed ID
16314606 View in PubMed
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Sick Leave within 5 Years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study.

https://arctichealth.org/en/permalink/ahliterature272248
Source
PLoS One. 2015;10(6):e0130298
Publication Type
Article
Date
2015
Author
Tina Birgitte Wisbech Carstensen
Per Fink
Eva Oernboel
Helge Kasch
Troels Staehelin Jensen
Lisbeth Frostholm
Source
PLoS One. 2015;10(6):e0130298
Date
2015
Language
English
Publication Type
Article
Keywords
Accidents, Traffic
Aged
Case-Control Studies
Denmark
Follow-Up Studies
Humans
Neck Pain - etiology
Prospective Studies
Quality of Life
Registries - statistics & numerical data
Risk factors
Sick Leave - statistics & numerical data
Surveys and Questionnaires
Whiplash Injuries - complications
Wounds and Injuries - complications
Abstract
10-22% of individuals sustaining whiplash trauma develop persistent symptoms resulting in reduced working ability and decreased quality of life, but it is poorly understood why some people do not recover. Various collision and post-collision risk factors have been studied, but little is known about pre-collision risk factors. In particular, the impact of sickness and socioeconomic factors before the collision on recovery is sparsely explored. The aim of this study was to examine if welfare payments received within five years pre-collision predict neck pain and negative change in provisional situation one year post-collision.
719 individuals with acute whiplash trauma consecutively recruited from emergency departments or primary care after car accidents in Denmark completed questionnaires on socio-demographic and health factors immediately after the collision. After 12 months, a visual analogue scale on neck pain intensity was completed. 3595 matched controls in the general population were sampled, and national public register data on social benefits and any other welfare payments were obtained for participants with acute whiplash trauma and controls from five years pre-collision to 15 months after. Participants with acute whiplash trauma who had received sickness benefit for more than 12 weeks pre-collision had increased odds for negative change in future provisional situation (Odds Ratio (OR) (95% Confidence Interval (CI) = 3.8 (2.1;7.1)) and future neck pain (OR (95%CI) = 3.3 (1.8;6.3)), controlling for other known risk factors. Participants with acute whiplash trauma had weaker attachment to labour market (more weeks of sick leave (?2(2) = 36.7, p
Notes
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PubMed ID
26098860 View in PubMed
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The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills.

https://arctichealth.org/en/permalink/ahliterature70486
Source
Psychosom Med. 2005 Nov-Dec;67(6):897-905
Publication Type
Article
Author
Lisbeth Frostholm
Per Fink
Eva Oernboel
Kaj S Christensen
Tomas Toft
Frede Olesen
John Weinman
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.
Source
Psychosom Med. 2005 Nov-Dec;67(6):897-905
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude to Health
Communication
Comparative Study
Family Practice - education - methods - standards
Female
Follow-Up Studies
Health Services Research
Health status
Humans
Male
Middle Aged
Multivariate Analysis
Patient satisfaction
Personality Inventory
Physicians - psychology - standards
Prognosis
Psychiatric Status Rating Scales
Questionnaires
Referral and Consultation - standards
Regression Analysis
Research Support, Non-U.S. Gov't
Somatoform Disorders - diagnosis - psychology - therapy
Teaching
Abstract
OBJECTIVE: To identify predictors of patient satisfaction among a range of patient and practitioner variables. In particular, to focus on patients' illness perceptions and the impact of a randomized controlled trial on the training of physicians in general communication skills and how to treat patients presenting with poorly defined illness. METHODS: A randomized controlled follow-up study conducted in 28 general practices in Aarhus County, Denmark. Half of the physicians were randomized into an educational program on treatment of patients presenting with medically unexplained symptoms (somatization). One thousand seven hundred eighty-five general practice attenders presenting a new health problem completed questionnaires on illness perceptions, physical functioning, and mental distress before the consultation. After the consultation, a questionnaire including relational and communicative domains of patient satisfaction with the current consultation was completed. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Predictors of patient satisfaction were determined by logistic regression. RESULTS: A large number of patient and practitioner variables predicted satisfaction in univariate logistic regression models. Results from a multivariate logistic model showed that the illness perceptions "uncertainty" (patient not knowing what is wrong) and "emotional representations" (the complaint making the patient feel worried, depressed, helpless, afraid, hopeless) predicted dissatisfaction at OR (CI) = 1.8 (1.3-2.4), p
PubMed ID
16314594 View in PubMed
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