Health anxiety and characteristics of self-initiated general practitioner consultations

Health anxiety has been hypothesized to lead to a cycle of repeated medical consultations. We investigated the relationship of health anxiety to patie nts' frequency of general practitioner visits, and to their expectations ab out the index visit in 200 general practice attenders. Health anxiety score s declined modestly with age, and were similar in men and women. Frequency of visits rose from 2.6 per year in the lowest decile of health anxiety to 4.2 in the highest (p=0.033). Across the same range, the odds of seeking ad vice prior to visiting the doctor rose from 0.25 to 0.56 (p=0.034), and the odds of believing that a specialist referral would be needed rose from 0.2 2 to 0.48 (p=0.008). There was no association between health anxiety and pr evious referral for investigation of symptoms that had not resulted in a me dical diagnosis, nor with attitudes to prescriptions, possibly because ther e was little variation in either. In this population, absolute levels of he alth anxiety were low. Nevertheless, within this "normal" range, there was an association between level of health anxiety and frequency of visiting, a nd with expectations for the index visit. The findings support the health a nxiety model as predicting use of services by psychologically normal person s. (C) 1998 Elsevier Science Inc.