Health anxiety and characteristics of self-initiated general practitioner consultations

Health anxiety has been hypothesized to lead to a cycle of repeated medical consultations. We investigated the relationship of health anxiety to patients' frequency of general practitioner visits, and to their expectations about the index visit in 200 general practice attenders. Health anxiety scores declined modestly with age, and were similar in men and women. Frequency of visits rose from 2.6 per year in the lowest decile of health anxiety to 4.2 in the highest (p=0.033). Across the same range, the odds of seeking advice prior to visiting the doctor rose from 0.25 to 0.56 (p=0.034), and the odds of believing that a specialist referral would be needed rose from 0.22 to 0.48 (p =0.008). There was no association between health anxiety and previous referral for investigation of symptoms that had not resulted in a medical diagnosis, nor with attitudes to prescriptions, possibly because there was little variation in either. In this population, absolute levels of health anxiety were low. Nevertheless, within this "normal" range, there was an association between level of health anxiety and frequency of visiting, and with expectations for the index visit. The findings support the health anxiety model as predicting use of services by psychologically normal persons.