Use of community support services by middle-aged and older patients with psychotic disorders.
OBJECTIVE
The study sought to determine the degree to which use of community services is related to predisposing, enabling, and need factors among older patients with psychotic disorders who live in the community and to assess whether high use of community services is associated with improving or declining psychopathology.


METHODS
The sample consisted of 89 middle-aged and elderly community-dwelling patients with schizophrenia or other psychotic disorders. Assessments at baseline and two follow-ups at six-month intervals included measures of psychopathology, well-being, and social adjustment, in addition to the frequency of use of 17 formal community services in three categories-psychological, social, and daily living services.


RESULTS
Ninety-two percent of patients reported use of community support services. The mean number of annual service contacts per patient was 36.6 for psychological services, 81 for social services, and 39.7 for daily living services. High users of psychological services were younger and experienced more severe positive psychotic symptoms and depressive symptoms. High users of social services were of higher socioeconomic status, more likely to be female, and had a longer history of psychosis, more cognitive deficits, and more severe negative psychotic and depressive symptoms. Patients who used daily living services were older, had poorer functional health status and more cognitive deficits, and had more severe negative psychotic and depressive symptoms. A trend was noted for high users of social services to experience relief from depressive symptoms over time.


CONCLUSIONS
Use of community services is common among older outpatients with psychotic disorders, but its frequency varies as a function of patient characteristics.
Shaw
W S
WS
Department of Psychiatry, Georgetown University Medical Center, Washington, DC, USA.
Patterson
T L
TL
Semple
S J
SJ
Halpain
M C
MC
Koch
W L
WL
Harris
M J
MJ
Grant
I
I
Jeste
D V
DV
D000368:Aged; D015331:Cohort Studies; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000628:therapy; D012944:Social Support; D016896:Treatment Outcome; D014600:Utilization Review