Social Psychiatry and Psychiatric Epidemiology

, Volume 50, Issue 1, pp 125–132 | Cite as

Decrease in unmet needs contributes to improved motivation for treatment in elderly patients with severe mental illness

  • Jolanda StobbeEmail author
  • André I. Wierdsma
  • Rob M. Kok
  • Hans Kroon
  • Marja Depla
  • Cornelis L. Mulder
Original Paper



To investigate the pattern of associations between changes in unmet needs and treatment motivation in elderly patients with severe mental illness.


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.


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).


Our findings suggest that a decrease in unmet needs is associated with improvements in motivation for treatment.


Assertive outreach CANE Needs Elderly Severe mental illness Treatment motivation 



This study was funded by BavoEuropoort, a department of Parnassia Psychiatric Institute, a Center for Mental Health Care, Rotterdam, the Netherlands. They had no role in the study design, collection of data, analysis, interpretation of data, or in the decision to submit the report for publication. JS, CLM, and RMK are employees of Parnassia Psychiatric Institute. All authors declare that they have no conflicts of interests and none of the authors received payments as a consequence of authorship for this manuscript. The authors thank David Alexander for his careful reading of the manuscript.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jolanda Stobbe
    • 1
    • 2
    Email author
  • André I. Wierdsma
    • 1
  • Rob M. Kok
    • 3
  • Hans Kroon
    • 4
  • Marja Depla
    • 5
  • Cornelis L. Mulder
    • 1
    • 2
  1. 1.Department of Psychiatry, Epidemiological and Social Psychiatric Research InstituteErasmus University Medical CenterRotterdamThe Netherlands
  2. 2.Department BavoEuropoort, Centre for Mental Health CareParnassia Psychiatric InstituteRotterdamThe Netherlands
  3. 3.Department Parnassia, Centre for Mental Health CareParnassia Psychiatric InstituteThe HagueThe Netherlands
  4. 4.Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
  5. 5.Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands

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