OBJECTIVE: To study the health problems presented to general practitioners by disaster survivors who received specialized ambulatory mental health care. DESIGN: (Longitudinal) case-control study based on general practitioners' electronic medical records. SETTING: General practice and a mental health institution (MHI) in Enschede, the Netherlands. SUBJECTS: A total of 728 adult disaster survivors who were registered in 30 study practices and had attended a specialized mental health institution (MHI group), and 728 practice-matched controls. MAIN OUTCOME MEASURES: Attendance rates in general practice before and after the disaster; health problems presented to the GP, classified according to the International Classification of Primary Care. RESULTS: Disaster survivors in the MHI group reported higher GP attendance rates pre- and post-disaster and more health problems than controls. In the year post-disaster, the MHI group reported an increase in psychological, medically unexplained physical symptoms (MUPS), gastrointestinal and musculoskeletal problems, compared with the year pre-disaster. Controls, survivors themselves, showed also an increase in psychological problems in the year post-disaster compared with the year pre-disaster. CONCLUSION: General practitioners should be aware of an increase in consultations and health problems among patients who also receive mental health care following a disaster. The services of GP and mental health care professionals should be integrated when supporting disaster victims. Information on severity of exposure to disasters should be included in disaster databases.
OBJECTIVE: To study the health problems presented to general practitioners by disaster survivors who received specialized ambulatory mental health care. DESIGN: (Longitudinal) case-control study based on general practitioners' electronic medical records. SETTING: General practice and a mental health institution (MHI) in Enschede, the Netherlands. SUBJECTS: A total of 728 adult disaster survivors who were registered in 30 study practices and had attended a specialized mental health institution (MHI group), and 728 practice-matched controls. MAIN OUTCOME MEASURES: Attendance rates in general practice before and after the disaster; health problems presented to the GP, classified according to the International Classification of Primary Care. RESULTS: Disaster survivors in the MHI group reported higher GP attendance rates pre- and post-disaster and more health problems than controls. In the year post-disaster, the MHI group reported an increase in psychological, medically unexplained physical symptoms (MUPS), gastrointestinal and musculoskeletal problems, compared with the year pre-disaster. Controls, survivors themselves, showed also an increase in psychological problems in the year post-disaster compared with the year pre-disaster. CONCLUSION: General practitioners should be aware of an increase in consultations and health problems among patients who also receive mental health care following a disaster. The services of GP and mental health care professionals should be integrated when supporting disaster victims. Information on severity of exposure to disasters should be included in disaster databases.
Authors: Dirk-Jan den Ouden; Peter G van der Velden; Linda Grievink; Mattijn Morren; Anja J E Dirkzwager; C Joris Yzermans Journal: BMC Public Health Date: 2007-07-24 Impact factor: 3.295