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Dyspepsia and Health Care Seeking in a Community (How Important Are Psychological Factors?)

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Abstract

The factors that drive subjects with dyspepsiain the community to seek medical care are uncertain. Weaimed to identify whether psychological factors explainhealth care utilization among subjects with dyspepsia. A sample of residents of westernSydney selected randomly from the electoral rolls wasmailed a validated self-report questionnaire. Dyspepsiawas defined as pain or discomfort centered in the upper abdomen. Potential predictors ofphysician visits tested included gastrointestinalsymptoms, neuroticism (by the Eysenck PersonalityQuestionnaire), psychological morbidity (General HealthQuestionnaire), and sexual, physical, and emotional abuse(based on standardized criteria). Among 730 subjects,13% (95% CI 10.3-15.2%) had dyspepsia and 70% (95% CI59.8-79.5%) had sought medical care. Subjects with dyspepsia had significantly higher neuroticismand psychological morbidity scores and reportedchildhood emotional abuse more often than those withoutdyspepsia (all P < 0.05), but none of these wereindependent predictors. Male gender (OR = 0.58, 95% CI0.37- 0.91), greater pain severity (OR = 2.49, 95% CI2.12-2.91, P < 0.01), and meeting the Rome criteriafor irritable bowel (OR = 2.0, 95% CI 1.06-3.78) wereassociated with dyspepsia subjects seeing a physician oralternative therapist for abdominal pain or discomfort,explaining 32% of the deviance. Pain severity (OR =1.39, 95% CI 1.22-1.58) and symptoms of five or more years duration (OR = 5.73, 95% CI 3.71-8.87)were predictive of dyspepsia subjects ever seeking carefor abdominal pain or discomfort, explaining 15% of thedeviance. Psychological factors were not significant predictors of seeking medical attention indyspepsia. Health care seeking among community subjectswith dyspepsia is explained in part by symptom severityand duration but not by neuroticism, psychological morbidity, or a history of abuse.

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Talley, N.J., Boyce, P. & Jones, M. Dyspepsia and Health Care Seeking in a Community (How Important Are Psychological Factors?). Dig Dis Sci 43, 1016–1022 (1998). https://doi.org/10.1023/A:1018878717715

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