Erl. Williams et al., Psychiatric status, somatisation, and health care utilization of frequent attenders at the emergency department - A comparison with routine attenders, J PSYCHOSOM, 50(3), 2001, pp. 161-167
Seventy-seven frequent attenders at an emergency department (ED) in an inne
r-city hospital in the UK (defined as seven or more visits in the previous
12 months) were compared with 182 patients who were attending the same depa
rtment on a routine basis. Patients completed the Schedules for Clinical As
sessment in Neuropsychiatry (SCAN) and the Short Form (SF)-36. information
was obtained on 64% of the frequent attenders and 45% underwent a detailed
psychiatric assessment. Of the frequent attenders, 45% had psychiatric diso
rder and 49% had some form of an alcohol-related disorder. Compared with ro
utine attenders, frequent attenders reported lower health status, had more
psychiatric disorder (odds ratio: OR=8.2, 95% confidence interval: CI=3.8-1
8.1), had more general hospital admissions (OR=19.9, 95% CI=8.3-47.8), more
psychiatric admissions (OR=167.5, 95% CI=9.5-2959.0), and more GP visits (
95% CI for difference = -10.2 to -5.7). There was no evidence that frequent
attenders had more somatisation than routine attenders. Specific treatment
and management strategies need to he developed for this group of patients,
although a substantial proportion may be difficult to engage in the treatm
ent process. (C) 2001 Elsevier Science Inc. All rights reserved.