Phobias Deter Chronically Ill From Seeking Regular Treatment

Phobic disorder topped the list of psychiatric conditions diagnosed among those without ongoing care for their chronic conditions. Depression, alcohol disorder and obsessive-compulsive disorder ran close behind, the 1993-96 follow-up studies showed.

"We found it somewhat surprising that phobic disorders figured so importantly among the disorders," said Lisa Cooper-Patrick, MD, MPH, lead author of the study. "It's more than twice as prevalent in this group as in the general population, and that makes this finding both concerning and important."

Cooper-Patrick and colleagues studied 963 individuals with chronic diseases who were getting no regular medical care at follow-up points across 13 years and found that 44 percent had active psychiatric disorders.

The researchers concluded that these psychiatric disorders may keep many persons with chronic diseases from the ongoing medical care they require to control their symptoms, prevent long-term consequences, function maximally, and achieve their highest levels of well-being. The results of the study appear in the current issue of the International Journal of Psychiatry in Medicine.

The scientists hypothesize a few reasons for the link between psychiatric disorders and persistent lack regular medical care. Failing to follow up with medical care may result from the impaired physical, mental, social and role functioning associated with psychiatric disorders. A loss of employment and income often associated with mental and physical illness can result in a loss of medical coverage and may deter patients from seeking medical care.

"Common psychiatric conditions should play an important role in studies of quality and continuity of care and in efforts to optimize health outcomes for a complete population and not just for those who regularly use health services," says Cooper-Patrick.

Funding support for the research was provided by the Robert Wood Johnson Foundation, the National Institute of Mental Health, and the National Institute on Alcohol Abuse and Alcoholism.