title: Patient-rated mental health needs and quality of life improvement.
abstract: BACKGROUND
  Patient-rated unmet need is cross-sectionally associated with quality of life. Its longitudinal relationship has not been established.
  
  
  OBJECTIVE
  To test the hypotheses that: (a) higher patient-rated unmet need is associated with lower individual quality of life assessments by a patient over time; and (b) reduction in patient-rated unmet need precedes improvement in quality of life.
  
  
  METHODS
  One hundred and one individuals using adult mental health services were asked to complete 6-monthly questionnaires, comprising quality of life (Manchester Short Assessment of Quality of Life, MANSA) and unmet need (Camberwell Assessment of Need Short Appraisal Schedule, CANSAS) assessments.
  
  
  RESULTS
  Seventy-three participants provided 240 separate pairs of consecutive assessments. Random effects regression models indicated an impact on current quality of life for both average level of unmet need (B= -0.23, 95% CI -0.29 to -0.17) and change in unmet need over the past month (B= -0.04, 95% CI -0.02).
  
  
  CONCLUSIONS
  Changes in patient-rated unmet needs may cause changes in quality of life.
authors.affiliation: Health Services Research Department, Institute of Psychiatry, Denmark Hill, London. m.slade@iop.kcl.ac.uk
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
authors.forename: Morven
authors.initials: M
authors.lastname: Leese
authors.forename: Sharon
authors.initials: S
authors.lastname: Cahill
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
mesh_terms: D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008131:London; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D020380:Needs Assessment; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires