THE COURSE OF PSYCHIATRIC-ILLNESS IN PRIMARY-CARE PATIENTS - A 1-YEARFOLLOW-UP

The aim of the study was to investigate the course of psychiatric illn ess in primary care patients. A 12-month follow-up study was conducted using a subsample of 93 patients, assessed by interviewing with the a id of the Present State Examination (PSE), from an original cohort of 388 primary care patients in a Swedish health district. The relationsh ips of the course of illness to psychosocial stress, perceived health, utilization of care and health insurance, and patient satisfaction wi th primary health care services were investigated.The results showed t hat at index contact, 32.1 % of the follow-up sample were psychiatric cases in need of treatment according to the screening procedure with t he Hopkins Symptom Check List (HSCL-25). The continuing cases constitu ted 19 % of the total follow-up sample, remitting cases. 13.1 %, new c ases, 4.8 % and non-cases. 63.1 %. Continuing cases had a significantl y higher utilization of ambulant care during follow-up. They also had 3 times more days of sick-leave. Poor perceived health at index contac t, measured using the Nottingham Health Profile (NHP), predicted that the patient became a continuing case during follow-up. Continuing case s, to a greater extent, showed psychosocial stress concerning unemploy ment, private economy and loneliness/social isolation. Continuing case s also showed a lower satisfaction with primary health care services i n all areas measured.