title: Perceived need for care and health care utilization among depressed and anxious patients with and without suicidal ideation.
abstract: BACKGROUND
  Information is scarce concerning the perceived needs and the amount of health-care utilization of persons with suicidal ideation (SI) compared to those without SI.
  
  
  OBJECTIVE
  To describe the needs and health care use of persons with and without SI and to investigate whether these differences are associated with the severity of the axis-I symptomatology.
  
  
  METHODS
  Data were obtained from 1,699 respondents with a depressive and/or anxiety disorder who participated in the Netherlands Study of Depression and Anxiety. Persons with and without SI were distinguished. Outcome variables were perceived needs and health-care utilization. We used multivariate regression in two models: (1) adjusted only for sociodemographic variables and (2) adjusted additionally for severity of axis-I symptomatology.
  
  
  RESULTS
  Persons with SI had higher odds for both unmet and met needs in almost all domains and made more intensive use of mental-health care. Differences in needs and health-care utilization of persons with and without SI were strongly associated with severity of axis I symptomatology.
  
  
  CONCLUSIONS
  Our results validate previous findings about perceived needs and health-care use of persons with SI. The results also suggest that suicidal persons are more seriously ill, and that they need more professional care, dedication, and specialized expertise than anxious and depressed persons without SI, especially in the domains of information and referral.
authors.affiliation: Department of Psychiatry, VU University Medical Center Amsterdam/GGZ inGeest, Amsterdam, The Netherlands. b.stringer@ggzingeest.nl
authors.forename: Barbara
authors.initials: B
authors.lastname: Stringer
authors.forename: Berno
authors.initials: B
authors.lastname: van Meijel
authors.forename: Merijn
authors.initials: M
authors.lastname: Eikelenboom
authors.forename: Bauke
authors.initials: B
authors.lastname: Koekkoek
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Verhaak
authors.forename: Ad J M F
authors.initials: AJ
authors.lastname: Kerkhof
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000523:psychology*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D012044:Regression Analysis; D012649:Self Concept; D059020:Suicidal Ideation; D055815:Young Adult