Utilization of somatic healthcare in Croatian patients with schizophrenia spectrum disorder, major depression, PTSD and the general population

Vjekoslav Jeleč, Žarko Bajić, Ivona Šimunović Filipčić, Ivana Portolan Pajić, Mirela Šentija Knežević, Ivan Miloloža, Delfa Radić-Krišto, Tomislav Benjak, Nenad Jakšić, Marina Šagud, Wei Wang, Igor Filipčić, Vjekoslav Jeleč, Žarko Bajić, Ivona Šimunović Filipčić, Ivana Portolan Pajić, Mirela Šentija Knežević, Ivan Miloloža, Delfa Radić-Krišto, Tomislav Benjak, Nenad Jakšić, Marina Šagud, Wei Wang, Igor Filipčić

Abstract

Background: Utilization of somatic healthcare services is highly predictive of the development of chronic physical illnesses and increased mortality risks. The objective of this study was to assess the differences in healthcare utilization among patients with schizophrenia spectrum disorders (SSD), major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) and the general population in Croatia.

Methods: We enrolled 566 Croatian participants from the general population, 282 with SSD, 178 with MDD, and 86 with PTSD. The primary outcome was a self-reported specialist consultation for non-psychiatric (e.g., somatic) causes within the previous 12 months.

Results: Although SSD patients with chronic physical illnesses were significantly more often hospitalized for physical illness than the general population, the proportion of patients who had a specialist consultation were equal in SSD and the general population. MDD and PTSD patients had significantly higher adjusted odds for specialist consultation than the general population and SSD patients (MDD compared to SSD: OR = 2.14; 95% CI 1.27-3.59; PTSD compared to SSD: OR = 2.03; 95% CI 1.00-4.10).

Conclusions: SSD patients' utilization of somatic healthcare is equal to the general population, despite their increased healthcare needs. However, their utilization is lower than in MDD and PTSD patients and, therefore, probably not adequate.

Trial registration: The study protocol was registered at ClinicalTrials.gov ( NCT02773108 ) on May 16, 2016.

Keywords: General population; Major depressive disorder; Posttraumatic stress disorder; Schizophrenia spectrum disorder; Specialist health care utilization.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Participants flow
Fig. 2
Fig. 2
Adjusted percentage of participants having a specialist consultation for non-psychiatric illness during the 12 months before the enrollment; error lines represent 95% confidence intervals; adjustment was done for: gender, age, marital status, working status, body mass index, self-perceived general health, number of physical illnesses, hospitalization during the 12 months before the enrollment

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