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NAVNEET KAPUR, ISABELLE HUNT, GARY MACFARLANE, JOHN McBETH, and FRANCIS CREED
Childhood experience and health care use in adulthood: Nested case—control study
The British Journal of Psychiatry 2004; 185: 134-139 [Abstract] [Full text] [PDF]
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[Read eLetter] Non-attendance in Psychiatric Outpatient Clinics: A similar phenomenon?
Muzaffar Husain   (10 August 2004)

Non-attendance in Psychiatric Outpatient Clinics: A similar phenomenon? 10 August 2004
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Muzaffar Husain,
SHO in Old Age Psychiatry
Leeds Mental Health Teaching NHS Trust, UK

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Re: Non-attendance in Psychiatric Outpatient Clinics: A similar phenomenon?

muzhusain{at}hotmail.com Muzaffar Husain

Kapur et al (1) describe very intriguing associations of childhood illness experience and childhood adversity on adult consultation behavior in a primary care setting. What is of even greater significance is that compared with normal attenders, a much greater proportion of frequent attenders are both diagnosed with a psychiatric disorder and referred on to specialist outpatient clinics.

But what we seem to wrestle with in community psychiatric outpatient care is not so much frequent attendance versus normal attendance, as it is no attendance versus some attendance (2).

Could it be that frequent attenders in primary care become non- attenders in specialist psychiatric care?

If so, could similar explanatory models that describe increased medical consultation in one setting be driving reduced psychiatric consultation in the other?

There is ample evidence to suggest that those who fail to attend out patient clinics do worse than those who don’t (3). This bit of new evidence could certainly add to evolving efforts in bringing this challenging group of patients within mental health care.

References

1. Kapur, N, Hunt, I, Macfarlane, G, McBeth, J and Creed F (2004) Childhood Experience and health care use in adulthood. Nested Case-Control Study. British Journal of Psychiatry, 185, 134-139

2. McIvor, R, Ek, E, and Carson, J (2004) Non attendance rates among patients attending different grades of psychiatrist and a clinical psychologist within a community mental health clinic. Psychiatric Bulletin , 28:5-7

3. Killaspy, H, Banerjee, S, King, M, and Lloyd , M (2000) Prospective controlled study of psychiatric outpatient non-attendance. Characteristics and outcome. British Journal of Psychiatry, 176, 160-165