Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning

Claudia Carmassi,1 Valerio Dell’Oste,1 Diana Ceresoli,1 Stefano Moscardini,2 Enrico Bianchi,3 Roberto Landi,4 Gabriele Massimetti,1 Cristiana Nisita,1 Liliana Dell’Osso1 1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2General Medicine Outpati...

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Autores principales:	Carmassi C, Dell’Oste V, Ceresoli D, Moscardini S, Bianchi E, Landi R, Massimetti G, Nisita C, Dell’Osso L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Frequent attenders primary care global functioning medically unexplained symptoms mental disorders DSM-5 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/a8d222c8eb0c46599d276459530ac006
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spelling	oai:doaj.org-article:a8d222c8eb0c46599d276459530ac0062021-12-02T07:26:28ZFrequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning1178-2021https://doaj.org/article/a8d222c8eb0c46599d276459530ac0062018-12-01T00:00:00Zhttps://www.dovepress.com/frequent-attenders-in-general-medical-practice-in-italy-a-preliminary--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Claudia Carmassi,1 Valerio Dell’Oste,1 Diana Ceresoli,1 Stefano Moscardini,2 Enrico Bianchi,3 Roberto Landi,4 Gabriele Massimetti,1 Cristiana Nisita,1 Liliana Dell’Osso1 1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2General Medicine Outpatient Clinic, ASL 5 Tuscany, Pisa, Italy; 3General Medicine Outpatient Clinic, ASL 6 Tuscany, Livorno, Italy; 4General Medicine Outpatient Clinic, ASL 2 Tuscany, Lucca, Italy Background: Frequent attenders (FAs), defined as patients reporting a disproportionate number of visits to general practitioners (GPs), may represent up to one-third of GP patients responsible for a high burden of care not always justified by the severity of the medical condition. The aim of this study was to explore sociodemographic and clinical characteristics of FAs of GP in Italy with particular attention to functional impairment. Methods: A total sample of 75 FAs (defined as individuals who had consulted GPs 15 times or more during 2015) of GPs of three primary care centers (Pisa, Livorno, and Lucca) in Italy were enrolled and assessed by sociodemographic scale, Structured Clinical Interview for DSM-5 (SCID-5), global functioning (Global Assessment of Functioning [GAF]), illness behavior and perceived health (Illness Behavior Inventory), and somatic comorbidity (Cumulative Illness Rating Scale). Results: Most of the sample were females, middle aged, married, or cohabiting, with low levels of education. One-third of FAs was low functioning (LF; GAF score <70), with no differences in the sociodemographic variables. Approximately 70.3% of the patients reported a current SCID diagnosis, in particular, major depressive disorder, somatic symptom disorders, and panic disorder, all being more frequent in LF patients. Half of the patients were taking a psychopharmacological therapy, mostly benzodiazepines (BDZs). Conclusion: Most FAs were female with current medical disorders, and LF. All claimed to be worried about their own health and perceived themselves as more impaired also regarding the health perception and social role. LF patients were, or had been more likely to be under psychopharmacological treatment. FAs seem to constitute a special population that should be carefully evaluated for mental disorders and appropriate treatment. Keywords: primary care, global functioning, medically unexplained symptoms, mental disorders, DSM-5Carmassi CDell’Oste VCeresoli DMoscardini SBianchi ELandi RMassimetti GNisita CDell’Osso LDove Medical PressarticleFrequent attendersprimary careglobal functioningmedically unexplained symptomsmental disordersDSM-5Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 115-125 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Frequent attenders primary care global functioning medically unexplained symptoms mental disorders DSM-5 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Frequent attenders primary care global functioning medically unexplained symptoms mental disorders DSM-5 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Carmassi C Dell’Oste V Ceresoli D Moscardini S Bianchi E Landi R Massimetti G Nisita C Dell’Osso L Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning
description	Claudia Carmassi,1 Valerio Dell’Oste,1 Diana Ceresoli,1 Stefano Moscardini,2 Enrico Bianchi,3 Roberto Landi,4 Gabriele Massimetti,1 Cristiana Nisita,1 Liliana Dell’Osso1 1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2General Medicine Outpatient Clinic, ASL 5 Tuscany, Pisa, Italy; 3General Medicine Outpatient Clinic, ASL 6 Tuscany, Livorno, Italy; 4General Medicine Outpatient Clinic, ASL 2 Tuscany, Lucca, Italy Background: Frequent attenders (FAs), defined as patients reporting a disproportionate number of visits to general practitioners (GPs), may represent up to one-third of GP patients responsible for a high burden of care not always justified by the severity of the medical condition. The aim of this study was to explore sociodemographic and clinical characteristics of FAs of GP in Italy with particular attention to functional impairment. Methods: A total sample of 75 FAs (defined as individuals who had consulted GPs 15 times or more during 2015) of GPs of three primary care centers (Pisa, Livorno, and Lucca) in Italy were enrolled and assessed by sociodemographic scale, Structured Clinical Interview for DSM-5 (SCID-5), global functioning (Global Assessment of Functioning [GAF]), illness behavior and perceived health (Illness Behavior Inventory), and somatic comorbidity (Cumulative Illness Rating Scale). Results: Most of the sample were females, middle aged, married, or cohabiting, with low levels of education. One-third of FAs was low functioning (LF; GAF score <70), with no differences in the sociodemographic variables. Approximately 70.3% of the patients reported a current SCID diagnosis, in particular, major depressive disorder, somatic symptom disorders, and panic disorder, all being more frequent in LF patients. Half of the patients were taking a psychopharmacological therapy, mostly benzodiazepines (BDZs). Conclusion: Most FAs were female with current medical disorders, and LF. All claimed to be worried about their own health and perceived themselves as more impaired also regarding the health perception and social role. LF patients were, or had been more likely to be under psychopharmacological treatment. FAs seem to constitute a special population that should be carefully evaluated for mental disorders and appropriate treatment. Keywords: primary care, global functioning, medically unexplained symptoms, mental disorders, DSM-5
format	article
author	Carmassi C Dell’Oste V Ceresoli D Moscardini S Bianchi E Landi R Massimetti G Nisita C Dell’Osso L
author_facet	Carmassi C Dell’Oste V Ceresoli D Moscardini S Bianchi E Landi R Massimetti G Nisita C Dell’Osso L
author_sort	Carmassi C
title	Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning
title_short	Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning
title_full	Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning
title_fullStr	Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning
title_full_unstemmed	Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning
title_sort	frequent attenders in general medical practice in italy: a preliminary report on clinical variables related to low functioning
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/a8d222c8eb0c46599d276459530ac006
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Frequent attenders in general medical practice in Italy: a preliminary report on clinical variables related to low functioning

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