{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:38:44Z","timestamp":1785584324435,"version":"3.56.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Psychiatry Med"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Generalized anxiety disorder is associated with higher rate of physical comorbities, unexplained symptoms, and health care utilization. However, the role of somatic symptoms in determining health care utilization is unclear. The present study aims to assess the association of frequent attendance of health care services between generalized anxiety disorder symptoms and somatic symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study was conducted cross-sectionally using the material of the 46-year follow-up survey of the Northern Finland Birth Cohort 1966. Altogether, 5585 cohort members responded to the questionnaires concerning health care utilization, illness history, physical symptoms, and generalized anxiety disorder-7 screening tool. Odds ratios belonging to the highest decile in health care utilization were calculated for generalized anxiety disorder symptoms and all (n\u2009=\u20094) somatic symptoms of Hopkins Symptom Checklist-25 controlled for confounding factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adjusted Odds ratios for being frequent attender of health care services were 2.29 (95% CI 1.58\u20133.31) for generalized anxiety disorder symptoms and 1.28 (95% CI 0.99\u20131.64), 1.94 (95% CI 1.46\u20132.58), 2.33 (95% CI 1.65\u20133.28), and 3.64 (95% CI 2.15\u20136.18) for 1, 2, 3, and 4 somatic symptoms, respectively. People with generalized anxiety disorder symptoms had on average a higher number of somatic symptoms (1.8) than other cohort members (0.9). Moreover, 1.6% of people without somatic symptoms tested positive for generalized anxiety disorder, meanwhile 22.6% of people with four somatic symptoms tested positive for generalized anxiety disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both generalized anxiety disorder symptoms and somatic symptoms are associated with a higher risk for being a health care frequent attender.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0091217417720894","type":"journal-article","created":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T09:47:00Z","timestamp":1502272020000},"page":"147-159","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["The association of generalized anxiety disorder and Somatic Symptoms with frequent attendance to health care services"],"prefix":"10.1177","volume":"52","author":[{"given":"Tero S","family":"Kujanp\u00e4\u00e4","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Jokelainen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"Unit of Primary Care, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha P","family":"Auvinen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"Unit of Primary Care, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku J","family":"Timonen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland"},{"name":"Unit of Primary Care, Oulu University Hospital, Oulu, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,8,9]]},"reference":[{"key":"bibr1-0091217417720894","first-page":"41","volume":"9","author":"Garfinkel SA","year":"1988","journal-title":"Health Care Financ Rev"},{"key":"bibr2-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.20.2.9"},{"key":"bibr3-0091217417720894","volume-title":"P\u00e4\u00e4kaupunkiseudun Eritt\u00e4in Kalliit Potilaat","author":"Kapiainen S","year":"2010"},{"key":"bibr4-0091217417720894","first-page":"3163","volume":"68","author":"Leskel\u00e4 R","year":"2013","journal-title":"Suomen l\u00e4\u00e4k\u00e4rilehti\u2009-\u2009Finlands l\u00e4kartidning"},{"key":"bibr5-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2004.03.007"},{"key":"bibr6-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(96)00287-5"},{"key":"bibr7-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/0163-8343(90)90002-T"},{"key":"bibr8-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/0163-8343(94)00059-M"},{"key":"bibr9-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1080\/028134398750003089"},{"key":"bibr10-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-36"},{"key":"bibr11-0091217417720894","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2000"},{"key":"bibr12-0091217417720894","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (ed.)\n                      Diagnostic and statistical manual of mental disorders\n                      . Arlington, VA: American Psychiatric Association, 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"issue":"11","key":"bibr13-0091217417720894","first-page":"15","volume":"62","author":"Wittchen HU","year":"2001","journal-title":"J Clin Psychiatry"},{"key":"bibr14-0091217417720894","first-page":"1362","volume":"51","author":"Belanger L","year":"2005","journal-title":"Can Fam Physician"},{"key":"bibr15-0091217417720894","doi-asserted-by":"publisher","DOI":"10.3109\/02813432.2014.920597"},{"key":"bibr16-0091217417720894","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2008.05.070082"},{"key":"bibr17-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(97)71478-6"},{"key":"bibr18-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2007.03.004"},{"key":"bibr19-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1097\/JGP.0b013e31819b87b2"},{"key":"bibr20-0091217417720894","doi-asserted-by":"publisher","DOI":"10.4321\/S0213-61632009000200003"},{"key":"bibr21-0091217417720894","doi-asserted-by":"publisher","DOI":"10.2190\/2X44-CR14-YHJC-9EQ3"},{"issue":"3","key":"bibr22-0091217417720894","first-page":"77","volume":"154","author":"Wittchen HU","year":"2012","journal-title":"MMW Fortschr Med"},{"issue":"8","key":"bibr23-0091217417720894","first-page":"24","volume":"63","author":"Wittchen HU","year":"2002","journal-title":"J Clin Psychiatry"},{"key":"bibr24-0091217417720894","doi-asserted-by":"publisher","DOI":"10.3109\/02813432.2016.1160631"},{"key":"bibr25-0091217417720894","doi-asserted-by":"publisher","DOI":"10.3109\/10401239709147790"},{"key":"bibr26-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-003-0449-y"},{"key":"bibr27-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2012.02405.x"},{"key":"bibr28-0091217417720894","doi-asserted-by":"publisher","DOI":"10.2190\/PM.41.4.c"},{"key":"bibr29-0091217417720894","first-page":"388","volume":"57","author":"Ridsdale L","year":"2007","journal-title":"Br J Gen Pract"},{"key":"bibr30-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(03)00564-6"},{"key":"bibr31-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2008.09.012"},{"key":"bibr32-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.26.5.545"},{"key":"bibr33-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(94)90145-7"},{"key":"bibr34-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(89)90010-7"},{"key":"bibr35-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"bibr36-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1002\/bs.3830190102"},{"key":"bibr37-0091217417720894","unstructured":"Koskela T.\n                      Terveyspalveluiden Pitk\u00e4aikaisen Suurk\u00e4ytt\u00e4j\u00e4n Ennustekij\u00e4t = the Prognostic Risk Factors for Long-Term Frequent use of the Primary Health Care Services\n                      . Kuopio, Finland: Kuopion yliopisto, 2008."},{"key":"bibr38-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1007\/s00038-013-0452-7"},{"key":"bibr39-0091217417720894","doi-asserted-by":"publisher","DOI":"10.5993\/AJHB.38.4.6"},{"key":"bibr40-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.06.021"},{"key":"bibr41-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01492.x"},{"key":"bibr42-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1111\/head.12296"},{"key":"bibr43-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1177\/0333102411430854"},{"key":"bibr44-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0b013e31817f9e80"},{"key":"bibr45-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e318238f12d"},{"key":"bibr46-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23240"},{"key":"bibr47-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12589"},{"key":"bibr48-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.520817"},{"key":"bibr49-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318160d093"},{"key":"bibr50-0091217417720894","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.74"}],"container-title":["The International Journal of Psychiatry in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0091217417720894","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0091217417720894","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0091217417720894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:14:38Z","timestamp":1777457678000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0091217417720894"}},"subtitle":["A cross-sectional study from the Northern Finland Birth Cohort 1966"],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":50,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1177\/0091217417720894"],"URL":"https:\/\/doi.org\/10.1177\/0091217417720894","relation":{},"ISSN":["0091-2174","1541-3527"],"issn-type":[{"value":"0091-2174","type":"print"},{"value":"1541-3527","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}