The psychiatric profile of patients with chronic diseases who do not receive regular medical care

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Objective: To assess the relationship between psychiatric disorders and lack of regular medical care in individuals with chronic medical diseases. Methods: Nine hundred sixty-three respondents to the household-based Baltimore Epidemiologic Catchment Area (ECA) Follow-Up Study were interviewed in 1981, 1982, and 1993-1996. The main outcome measures were: 1) not receiving regular care from a health professional for an active chronic medical condition in 1981, 2) persistent lack of regular medical care, and 3) leaving regular medical care. Results: In cross-sectional analyses, having a psychiatric disorder (OR 1.70, 95% CI 1.17-2.48) was associated with not receiving regular medical care. This was mostly due to individuals with phobic disorder (OR 1.57, 95% CI 1.02-2.43). In prospective analyses, depression (RR 2.4, p < 0.04) and alcohol abuse (RR 2.9, p < 0.001) predicted leaving regular medical care one year later. Phobic disorder (RR 2.8, p < 0.001) predicted leaving care thirteen years later. Conclusions: Psychiatric disorders appear to place an individual at risk for irregular medical care. Studies of the quality and continuity of care for patients with chronic medical conditions should include measures of common psychiatric conditions.

Original languageEnglish (US)
Pages (from-to)165-180
Number of pages16
JournalInternational journal of psychiatry in medicine
Issue number2
StatePublished - 1999


  • Chronic disease
  • Longitudinal care
  • Psychiatric disorders

ASJC Scopus subject areas

  • Psychiatry and Mental health


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