Psychologic Distress as a Longterm Predictor of Medical Utilisation

OBJECTIVE: To study baseline psychologic distress as a predictor of self-reported medical utilisation after nine years of follow-up. METHODS: in 1975-1978 we measured psychologic distress with a neuroticism scale in a general population sample of 826 women aged forty-five to sixty-four years. In the same study, and in a follow-up study nine years later, medical utilisation was quantified as the main outcome in terms of current treatment by a physician and current use of medication. RESULTS: The age and educational class adjusted odds ratio of baseline physician contact and use of medication for the upper versus the lower quintile of the neuroticism score were 3.3 (95% confidence interval (c.i.): 2.0-5.2) and 3.6 (95% c.i.: 2.2-5.7), respectively. When the baseline neuroticism scores were related to utilisation at follow-up the adjusted odds ratios were 2.1 (95% c.i.: 1.2-3.1) and 2.8 (95% c.i.: 1.8-4.5). However, in the subgroup of 352 women who did not report initial medical utilisation the odds ratios were 1.1 (95% c.i.: 0.5-2.4) and 1.4 (95% c.i.: 0.6-3.1). CONCLUSION: Although an association between psychologic distress and medical utilisation was confirmed, psychologic distress did not predict utilisation in middle-aged women characterised at baseline as non-utilizers.