Patient needs four years after first psychiatric hospitalization in a Brazilian cohort

Abstract

Knowledge about the needs of psychiatric patients is essential for mental health care planning. However, research on met and unmet needs is still scarce, particularly in low-and middle-income countries. This study aimed to describe the patients' needs (met and unmet) at least four years after their first psychiatric hospitalization and to verify the role of demographic and clinical features as possible predictors of these needs. Patients who had their first psychiatric admission between January 1, 2006 and December 31, 2007 at an inpatient unit in the city of Ribeirão Preto, Brazil, were eligible to participate in the study. Patients were contacted and face-to-face interviews were conducted by psychologists using the Camberwell Assessment of Need. Data were analyzed using zero-inflated negative binomial regression model. Of 933 eligible patients, 333 were interviewed. The highest level of needs was related to welfare benefits (32.4%, unmet=25.5%), followed by household skills (30.3%, unmet=3.0%), psychotic symptoms (29.4%, unmet=9.0%), psychological distress (27.6%, unmet=8.4%), physical health (24.3%, unmet=5.4%), daytime activities (19.5%, unmet=16.5%), and money (16.8%, unmet=9.0%). Fewer years of schooling, living with relatives, and unemployment at the moment of the first admission were significantly associated with a higher number of both met and unmet needs in the follow-up. Unmet needs were also more often reported by patients living alone. In conclusion, socioeconomic indicators were the best predictors of needs. The unmet needs related to welfare benefits point to the need for specific social and health policies.

Evaluation of Met and Unmet Needs in Patients with Severe Psychiatric Disorders and its Relation to the Quality of Life: A Cross-Sectional Study

“…In this study, which also included patients with substance-related disorders, the unmet need for psychotic symptoms was only 9%, which is significantly different from the current study due to the higher severity of the disorder and the higher percentage of schizophrenia disorders in our patients. This issue shows the change in patients' needs during the disorder ( 13 ).…”

“…Since then, numerous studies evaluated psychiatric patient needs and factors that influence them in many countries. More unmet needs were related to illness severity ( 12 ), socioeconomic status ( 13 ), lower quality of life ( 3 ), and more emergency department visits ( 14 ). Also, needs profiles were different among different countries and cultures ( 15 ).…”