Generalized anxiety disorder and health care utilization

• Main Author: Kujanpää, T. (Tero)
• Other Authors: Timonen, M. (Markku)
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Oulun yliopisto 2016
• Subjects: anxiety disorders; cost analysis; general practice; generalized anxiety disorder; health services; high utilizers of health care; screening; ahdistuneisuushäiriöt; kustannusanalyysi; perusterveydenhuolto; seulonta; terveyspalveluita paljon käyttävät; terveyspalvelut; yleistynyt ahdistuneisuushäiriö; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526212715

Abstract Generalized anxiety disorder (GAD) is a mental health problem, which is characterized by excessive anxiety and worry, problems that are difficult to control. In the general population, the 12-month prevalence of GAD is 2–3%, with the lifetime prevalence being about 5%. However, GAD is more prevalent among primary care utilizers i.e. approximately 5–8% of them suffer from this disorder. Earlier studies have revealed GAD to be associated with a high utilization of health care resources. There were four goals of the present study; i) to investigate the prevalence of GAD among Finnish health care high utilizers, ii) to examine the association between GAD and utilization of different health care services at the population level, iii) to determine whether there would be any association between frequent utilization of health care services, GAD and somatic symptoms and iv) to compare the costs associated with GAD in secondary care in Finland with those attributable to major depressive disorder (MDD). In addition, the Finnish translation of the 7-item GAD scale (GAD-7) was validated. In a sample (n=150) of health care high utilizers in northern Finland, the prevalence of GAD was found to be 4%; GAD-7 was a valid instrument for detecting GAD in these subjects. In Northern Finland 1966 Birth Cohort, there was a significant association between GAD and health care utilization. Those subjects who screened positive for GAD with GAD-7 made 112% more total health care visits than other individuals. The results were statistically significant when controlled for potential confounders. Both GAD symptoms and physical symptoms were risk factors for frequent attendance of health care services, and the individuals who tested positive for GAD exhibited a higher rate of physical symptoms. Secondary care costs of all patients with a new diagnosis of GAD or MDD were calculated 2 years before and after the diagnosis date using the information from the Finnish Hospital Discharge Registers and National Hospital Benchmarking Database. ...