title: Lack of motivation for treatment associated with greater care needs and psychosocial problems.
abstract: OBJECTIVE
  To compare the care needs and severity of psychosocial problems in older patients with severe mental illness (SMI) between those who were and were not motivated for treatment.
  
  
  METHODS
  Cross-sectional study in which we enrolled 141 outpatients with SMI aged 55 and older. Needs were measured using the Camberwell Assessment of Needs for the Elderly, and psychosocial problems with the Health of the Nation Outcome Scale 65+. Motivation for treatment was assessed using a motivation-for-change scale. Parametric and non-parametric tests were used to analyze differences between motivated and non-motivated patients. Explorative logistic regression analyses were used to establish, which unmet needs were associated with motivation.
  
  
  RESULTS
  Less-motivated patients had greater unmet care needs and more psychosocial problems than those who were motivated. Logistic regression analyses showed that lack of motivation was associated with greater unmet needs regarding daytime activities, psychotic symptoms, behavioral problems, and addiction problems.
  
  
  CONCLUSIONS
  Lack of treatment motivation was associated with more unmet needs and more severe psychosocial problems. Further research will be needed to identify other factors associated with motivation in older people with SMI and to investigate whether this group of patient benefits from interventions such as assertive outreach, integrated care or treatment-adherence therapy.
authors.affiliation: a Department of Psychiatry , Epidemiological and Social Psychiatric Research Institute , Erasmus MC , Rotterdam , The Netherlands.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Stobbe
authors.forename: Andre I
authors.initials: AI
authors.lastname: Wierdsma
authors.forename: Rob M
authors.initials: RM
authors.lastname: Kok
authors.forename: Hans
authors.initials: H
authors.lastname: Kroon
authors.forename: Marja
authors.initials: M
authors.lastname: Depla
authors.forename: Bert-Jan
authors.initials: BJ
authors.lastname: Roosenschoon
authors.forename: Cornelis L
authors.initials: CL
authors.lastname: Mulder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D020380:Needs Assessment; D012720:Severity of Illness Index; D012919:Social Behavior