title: Decrease in unmet needs contributes to improved motivation for treatment in elderly patients with severe mental illness.
abstract: OBJECTIVE
  To investigate the pattern of associations between changes in unmet needs and treatment motivation in elderly patients with severe mental illness.
  
  
  METHODS
  Observational longitudinal study in 70 patients treated by an assertive community treatment team for the elderly. Unmet needs and motivation for treatment were measured using the Camberwell assessment of needs for the elderly and the stages-of-change (SoC) scale, respectively, at baseline, after 9 and 18 months. SoC scores were dichotomized into two categories: motivated and unmotivated. Multinomial logistic regression analyses were conducted to determine whether changes in motivation were parallel to or preceded changes in unmet needs.
  
  
  RESULTS
  The number of patients who were not motivated for treatment decreased over time (at baseline 71.4 % was not motivated, at the second measurement 51.4 %, and at 18 months 31.4 % of the patients were not motivated for treatment). A decrease in unmet needs, both from 0-9 to 0-18 months was associated with remaining motivated or a change from unmotivated to becoming motivated during the same observational period (parallel associations). A decrease in unmet needs from 0 to 9 months was also associated with remaining motivated or a change from unmotivated to motivated during the 9-18 months follow-up (sequential associations).
  
  
  CONCLUSIONS
  Our findings suggest that a decrease in unmet needs is associated with improvements in motivation for treatment.
authors.affiliation: Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Center, PO Box 2040 Dp-0122, 3000 CA, Rotterdam, The Netherlands, j.stobbe@erasmusmc.nl.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Stobbe
authors.forename: André 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: Cornelis L
authors.initials: CL
authors.lastname: Mulder
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; 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; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D009042:Motivation; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D055815:Young Adult