Health service utilization in patients with major depressive disorder experiencing significant somatic symptoms in Korea

Background: This study investigated the patterns of health service utilization among patients with major depressive disorder (MDD) and significant somatic symptoms, who visited psychiatrists in a tertiary care setting. Methods: A total of 211 patients (51 males and 160 females) were recruited from a convenience sampling and assessed for severity of depressive and somatic symptoms. A structured questionnaire was employed to assess their pattern of healthcare service utilization, specifically, type of treatment first sought, out-of-pocket medical expenses, and time from onset of depressive symptoms to first treatment. Results: MDD patients with significant somatic symptoms tended to visit a non-psychiatrist physician first. Those with milder somatic symptoms who first visited non-physician practitioners spent a significantly greater amount on out-of-pocket medical expenses than did those who first visited physicians to get treatment. The patients with chief complaints of psychological and emotional symptoms were more likely to visit a psychiatrist first; however, a longer time interval lapsed before these patients received treatment. Conclusions: Patients with MDD experiencing significant symptoms are unlikely to access appropriate services in a timely manner. The results have implications for improving health care delivery for this population.