P69: Perceived need for mental health care and persistence of common mental health disorders in older adults consulting in primary care
Bibliographic record
Abstract
Background and objectives: Need for mental health care is rarely assessed using the patient perspective, which has previously been measured by the perceived need for care (PNC) (Meadows et al. 2002; Prins et al. 2009).Studies on PNC and its association with the course of depression and anxiety disorders are scarce, particularly in older adults.This study aims to assess the association between PNC and the persistence of common mental disorders (MD) among older adults.Method: This study included 170 older adults with a common MD recruited in primary care clinics and participating in a larger 3-wave longitudinal study (2011)(2012)(2013)(2014)(2015)(2016) in Quebec.An adapted version of the PNC Questionnaire (Meadows et al. 2000) was used in wave-3 (2015-2016) to assess the presence of unmet, met or no need.The persistence/remission of MD was measured by the presence/absence of at least one common MD at baseline (wave-1) and at follow-ups, 3 (wave-2) and 4 years (wave-3) later.Common MD were defined by the presence of depression or an anxiety disorder using self-reported (DSM-5) and administrative data (ICD-9, ICD-10).Multinomial regressions were carried out to assess PNC as a function of persistence of common MD controlling for demographic and clinical factors.Results: The prevalence of common MD at Wave-1 was 14% and 36% and 26% were persistent at follow-ups 3 and 4 years later.As opposed to those in remission, participants with a persistent MD at wave-2 were more likely to report a need [no need (REF); unmet need: OR 2.75, CI 1.17-6.45;met need: OR 2.28, CI 1.06-4.93].Older adults with a met need were more likely (OR 4.59; to have a persistent disorder than being in remission at wave-3 compared to participants without a perceived need.No significant association between older adults with a met and an unmet need was observed in regard to persistence of common MD.Conclusion: Our results suggest that older adults with a met and an unmet need are relatively similar with regards to persistence/remission of common MD.Future studies should focus on PNC and satisfaction with services and quality of life.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".