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Needs for care in psychiatric patients: a systematic review. I. General concepts and assessment measures. Needs for services

  • Antonio Lasalvia (a1), Benedetta Stefani (a1) and Mirella Ruggeri (a1)

Summary

Objective – In Italy, mental health care is in phase of reorganisation. In this frame the measurement of users' needs may be a useftil tool in planning individualised mental health service interventions and in their evaluation. Aims of the present study are (I) to highlight the basic concepts of 'needs for care' and give a brief description of the main needs assessment tools specifically developed for psychiatric patients; (II) to review studies assessing needs for mental health services in the general population; (III) to discuss the role played by the assessment of needs in planning mental health care. Methods – Studies published in the international literature from January 1980 to June 1999 were reviewed. The studies were located through a computerised search of the databases MEDLINE and PsycLit; in addition, the reference lists of the studies located through the computerised search and the content of main international psychiatric journals were manually scanned in order to avoid possible omissions. Studies assessing needs for services and studies assessing needs on individual level were separately reviewed. Both groups of studies, in turn, were divided in studies assessing needs for mental health care in the general population and in psychiatric patients. Results – Although most studies on needs for services used indirect methodologies and employed quite heterogeneous experimental design, they provide at large overlapping results. In the general population, about 60%- 70% of patients with anxiety, depression and other neurotic disorders and 30%-40% of psychotic patients do not receive any specialist mental health care, suggesting that the majority of subjects suffering from a psychiatric disorder do not receive the mental health care they need. Conclusions – Unmet needs for services show a higher frequency in patients with neurotic and depressive disorders, indicating a shortage in services delivery that should be taken into account both by psychiatrists and mental health planners. Moreover, the finding that a large number of patients suffering from psychotic disorders do not receive any kind of mental health care is of particular relevance for planning mental health services, since these subjects are usually the most problematic and difficult to treat.

Scopo – Nella fase di riorganizzazione dell'assistenza psichiatrica attualmente in corso in Italia, la valutazione dei bisogni degli utenti si pone come un valido ausilio tanto per la pianificazione dell'attività complessiva dei servizi, che per l'impostazione e la valutazione di strategic terapeutiche efficaci ed individualizzate. Il presente lavoro ha l'obiettivo di (I) puntualizzare il concetto di ‘bisogni di cura’ e passare in rassegna i principali strumenti di valutazione dei bisogni nei pazienti psichiatrici; (II) operare una revisione sistematica della letteratura sui bisogni di servizi di salute mentale nella popolazione generale; (III) discutere il ruolo giocato dalla valutazione dei bisogni nell'ambito della pianificazione dei servizi. Metodo – Mediante ricerca computerizzata (effettuata con i database MEDLINE e PsycLit) integrata da una ricerca manuale (realizzata consultando gli indici analitici delle principali riviste psichiatriche intemazionali), sono stati selezionati i lavori pubblicati sull'argomento da Gennaio 1980 a Giugno 1999. Sono stati considered separatamente gli studi che si occupano dei bisogni di servizi (relativi ad un generico bisogno di assistenza specialistica) da quelli che valutano i bisogni individuali (bisogni relativi a precise e specifiche tipologie di intervento e prestazioni fornite dai servizi di salute mentale). Entrambi i tipi di studi, a loro volta, sono stati ulteriormente differenziati in studi condotti nella popolazione generale e studi condotti su gruppi di pazienti psichiatrici. Risultati – Nonostante la maggioranza degli studi sui bisogni di servizi abbia utilizzato metodologie di tipo indiretto e sia stata realizzata con disegni sperimentali piuttosto eterogenei, i risultati appaiono in larga misura sovrapponibili. Nell'ambito della popolazione generale, il 60%-70% dei pazienti con disturbi dello spettro nevrotico ed il 30%-40% dei pazienti affetti da disturbi di tipo psicotico non è seguita dai servizi specialistici, il che fa supporre che la maggior parte dei soggetti con disturbi mentali non riceva tutta l'assistenza di cui ha bisogno. Conclusioni – I bisogni di servizi insoddisfatti si riscontrano con maggiore frequenza nei pazienti con disturbi dello spettro nevrotico e depressivo e questo fenomeno evidenzia una carenza che richiede senz'atro attenzione da parte sia dei clinici che degli amministratori. Inoltre, per la pianificazione dei servizi di salute mentale, assume particolare rilevanza il fatto che una quota cospicua dei pazienti affetti da disturbi di tipo psicotico sfugge all'attenzione dei servizi, in quanto essa rappresenta proprio la fascia di utenza più problematica e difficile da assistere.

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Corresponding author

Indirizzo per la corrispondenza: Dott.ssa Mirella Ruggeri, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Ospedale Policlinico, 37134 Verona. Fax: +39-045-585871 E-mail: mruggeri@borgoroma.univr.it

References

Hide All
Baker, R. & Hall, J.N. (1988). REHAB: a new assessment instrument for chronic psychiatric patients. Schizophrenia Bulletin 14,97111.
Balestrieri, M., Sytema, S., Gavioli, I. & Micciolo, R. (1989). Patterns of psychiatric care in South-Verona and Groningen. A case-register follow-up study. Ada Psychiatrica Scandinavica 80, 437444.
Banerjee, S. (1998). Needs of special groups: the elderly. International Review of Psychiatry 10, 30133.
Barrowclough, C., Marshall, M., Lockwood, A., Quinn, J. & Sellwood, W. (1998). Assessing relatives' needs for psychosocial interventions in schizophrenia: a relatives' version of the Cardinal Needs Schedule. Psychological Medicine 28, 531542.
Bebbington, P.E. (1990). Population surveys of psychiatric disorder and the need for treatment. Social Psychiatry and Psychiatric Epidemiology 25, 3340.
Bebbington, P.E., Brewin, C.R., Marsden, L. & Lesage, A. (1996). Measuring the need for psychiatric treatment in the general population: the community version of the MCR Needs for Care Assessment. Psychological Medicine 26, 229236.
Bebbington, P.E., Mardsen, L. & Brewin, C.R. (1997). The need for psychiatric treatment in the general population: the Camberwell Needs for Care survey. Psychological Medicine 27, 821834.
Black, S.B., Rabins, P.V., German, P., McGuire, M. & Roca, R. (1997). Need and unmet need for mental health care among elderly public housing residents. Gerontologist 6, 1997.
Bouras, N., Webb, Y., Clifford, P., Papadatos, Y. & Zouni, M. (1992). A needs survey among patients in Leros asylum. British Journal of Psychiatry 161, 7579.
Bredshaw, J. (1972). A taxonomy of social need. In Problems and Progress in Medical Care: Essays on Current Research (ed. McLachlan, G.). Oxford University Press: London.
Brewin, C.R. (1992). Measuring individual needs for care and services. In Measuring Mental Health Needs (ed. Thornicroft, G., Brewin, C.R. & Wing, J.). Gaskell: London.
Brewin, C.R. & Wing, J.K. (1989). MRC Needs for Care Assessment Manual for Version Two. MRC Social Psychiatric Unit, Institute of Psychiatry: London.
Brewin, C.R. & Wing, J.K. (1993). The MRC needs for care assessment: progress and controversy. Psychological Medicine 23, 837841.
Brewin, C.R., Wing, J.K., Mangen, S.P., Brugha, T.S. & MacCarthy, B. (1987). Principles and practice of measuring needs in the long-term mentally ill: the MRC Needs for Care Assessment. Psychological Medicine 17,971981.
Brewin, C.R., Wing, J.K., Mangen, S.P., Brugha, T.S., MacCarthy, B. & Lesage, A. (1988). Needs for care among the long-term mentally ill: a report from the Camberwell High Contact Survey. Psychological Medicine 18, 457468.
Brugha, T.S., Wing, J.K., Brewin, C.R., MacCarthy, B., Mangen, S.P., Lesage, A & Mumford, J. (1988). The problems of people in longterm psychiatric day care. Psychological Medicine 18, 443456.
Brugha, T.S., Wing, J.K. & Smith, B.L. (1989). Physical health of the long-term mentally ill in the community. Is there unmet need? British Journal of Psychiatry 155, 777781.
Brugha, T.S., Smith, B. & Wing, J.K. (1990). Unmet needs for medical care. British Journal of Psychiatry 157, 453.
Brown, G.W. & Harris, T.O. (1978). Social Origin of Depression. Tavistock: London.
Caldas de Almeida, J.M. (1997). Population needs assessment for mental health services. Prospects for the future. In Making Rational Mental Health (ed. Tansella, M.). Epidemiologia e Psichiatria Sociale Monograph Supplement 1, II Pensiero Scientifico Editore: Roma.
Carr-Hill, R.A., Sheldon, T.A., Smith, P., Martin, S., Peacock, S. & Hardman, G. (1994). Allocating resources to health authorities: development of methods for small area analysis of use of inpatient services. British Medical Journal 309, 10461049.
Cheah, Y.C., Parker, G., Hadzi-Pavlovic, D., Gladstone, G. & Eyers, K. (1998). Development of a measure profiling problems and needs of psychiatric patients in the community. Social Psychiatry and Psychiatric Epidemiology 33, 337344.
Cohen, A. & Eastman, N. (1997). Needs assessment for mentally disordered offenders and others requiring similar services. British Journal of Psychiatry 171, 412416.
Compton, S. & Brugha, T. (1988). Problems in monitoring needs for care of long term psychiatric patients: evaluating a service for casual attenders. Social Psychiatry and Psychiatric Epidemiology 23, 121125.
Comtois, G., Morin, C., Lesage, A., Lalonde, P., Likavcanova, E. & L'Ecuyer, G. (1998). Patients versus rehabilitation practitioners: a comparison of assessment of needs for care. Canadian Journal of Psychiatry A3, 159165.
Corrigan, P.W., Bucan, B. & McCraken, S. (1995). The Needs and Resources Assessment Interview for severely mentally adults. Psychiatric Services 46, 504505.
Corrigan, P.W., Bucan, B. & McCraken, S. (1996). Can severely mentally ill adults reliably report their needs? Journal of Nervous and Mental Disease 184, 523529.
Davies, B. & Challis, D. (1986). Matching Resources to Needs in Community Care. Gower: London.
Dew, M.A., Bromet, E.J. & Shulberg, H.C. (1988). Factor affecting helpseeking during depression in a community sample. Journal of Affective Disorders 14, 223234.
Dick, P.H., Reid, D., Simpkins, A. & Durham, T. (1997). Who's assessing needs-led assessment? Psychiatric Bulletin 21, 290293.
Dilling, H. & Weyerer, S. (1980). Incidence and pievalence of treated mental disorders. Health care planning in a small-town-rural region of Upper Bavaria. Ada Psychiatrica Scandinavica 61, 209222.
Faulkner, L.R. & Goldman, C.R. (1997). Estimating psychiatric manpower requirements based on patients' needs. Psychiatric Services 48, 666670.
Flaherty, L.T., Weist, M.D. & Warner, B.S. (1996). School-based mental health services in the United States: history, current model and needs. Community Mental Health Journal 32, 341352.
Flisher, A.J., Kramer, R.A., Grosser, R.C., Alegria, M., Bird, H.R., Bourdon, K.H., Goodman, S.H., Greenwald, S., Horwitz, S.M., Moore, R.E., Narrow, W.E. & Hoven, C.W. (1997). Correlates of unmet need for mental health services by children and adolescents. Psychological Medicine 27, 11451154.
Folstein, M.F., Folstein, S.E. & McHugh, P.R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.
Ford, P. & Keady, J. (1997). Assessment of older people with mental health needs. Elderly Care 9, 1214.
Frances, A., First, M.B. & Pincus, H.A. (1995). DSM-IV Guidebook. American Psychiatric Press: Washigton, DC.
Freyers, T. (1979). Estimation of need on the basis of case register study. In Estimating Need for Mental Health Care (ed. Hafner, H.). Springer-Verlag: Berlin, Heidelberg.
Galletta, M., Lasalvia, A. & Ruggeri, M. (1999). I bisogni di cura dei pazienti psichiatrici in relazione alle loro caratteristiche demografiche, cliniche, sociali e di interazione con i servizi. Rivista Sperimentale di Freniatria 4, 237249.
Garralda, E. (1998). Needs of special groups: children. International Review of Psychiatry 10, 134135.
Glover, G.R., Robin, E., Emami, J. & Arabsheibani, G.R. (1998). A needs index for mental health care. Social Psychiatry and Psychiatric Epidemiology 33, 8996.
Goldberg, D. & Hillier, V.F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine 9, 139145.
Goldberg, D. & Huxley, P. (1980). Mental Illness in the Community. The Pathway to Psychiatric Care. Tavistock: London.
Hagnell, O. (1966). A Prospective Study of the Incidence of Mental Disorder. Svenska bokforlaget: Lund.
Hansson, L., Bjorkman, T. & Svensson, B. (1995). Inter-rater reliability of the Swedish version of the Camberwell Assessment of Needs instrument and results from a cross-sectional study. Ada Psychiatrica Scandinavica 92, 285293.
Herman, D.B., Struening, E.L & Barrow, S.M. (1993). Self-assessed need for mental health services among homeless adults. Hospital and Community Psychiatry 44, 11811183.
Hirsh, S. (1988). Psychiatric Beds and Resources: Factors Influencing Bed Use and Service Planning. Gaskell: London.
Hogg, L.I. & Marshall, M. (1992). Can we measure need in the homeless mentally ill? Using the MRC Needs for Care Assessment in hostels for the homeless. Psychological Medicine 22, 10271034.
Holloway, F. (1991a). Day care in an inner city. I. Characteristics of attenders. British Journal of Psychiatry 158, 805810.
Holloway, F. (1991b). Day care in an inner city. II. Quality of the services. British Journal of Psychiatry 158, 810816.
Holloway, F. (1994). Need in community psychiatry: a consensus is required. Psychiatric Bulletin 18, 321323.
Horwitz, A.V. (1996). Seeking and receiving mental health care. Current Opinion in Psychiatry 9, 158161.
House of Commons (1990). The National Health Service and Community Care Act. HMSO: London.
Hurry, J. & Sturt, E. (1981). Social performance in a population sample: relation to psychiatric symptoms. In What is a Case? The Problem of Definition in Psychiatric Community Survey (ed. Wing, J.K., Bebbington, P.E. and Robins, L.). Grant Maclntyre: London.
Huyse, F.J. (1997). From consultation to complexity of care prediction and health service needs assessment. Journal of Psychosomatic Research 43, 233240.
Jarman, B. (1984). Unprivileged areas: validation and distribution of scores. British Medical Journal 289, 15871592.
Jenkins, R., Bebbington, P., Brugha, T., Farrell, M., Gill, B., Lewis, G., Meltzer, H. & Petticrew, M. (1997). The National Psychiatric Morbidity Survey of Great Britain n strategy and methods. Psychological Medicine 27, 765774.
Jenkins, R., Bebbington, P., Brugha, T.S., Farrell, M., Gill, B., Lewis, G. & Meltzer, H. (1998). British psychiatric morbidity survey. British Journal of Psychiatry 173, 47.
Johnson, S., Thornicroft, G., Phelan, M. & Slade, M. (1996). Assessing needs for mental health services. In Mental Health Outcome Measures (ed. Thornicroft, G. and Tansella, M.). Springer-Verlag: Berlin, Heidelberg.
Judd, L.L., Paulus, M.P., Wells, K.B. & Rapaport, M.H. (1996). Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. American Journal of Psychiatry 153, 14111417.
Katz, S.J., Kessler, R.C., Frank, R.G., Leaf, P., Lin, E. & Edlund, M. (1997). The use of outpatient mental health services in the United States and Ontario: the impact of mental morbidity and perceived need for care. American Journal of Public Health 87, 11361143.
Kazarian, S.S., McCabe, S.B. & Joseph, L.W. (1997). Assessment of service needs of adult psychiatric inpatients: a systematic approach. Psychiatric Quarterly 68, 523.
Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.U. & Kendler, K.S. (1994). Life-time and 12month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry 51, 819.
Kessler, R.C., Frank, R.G., Edlund, M., Katz, S.J., Lin, E. & Leaf, P. (1997). Differences in the use of psychiatric outpatients services between the United States and Ontario. New England Journal of Medicine 336, 551557.
Krawiecka, M., Goldberg, D. & Vaughn, M. (1977). A standardised psychiatric assessment scale for rating chronic psychiatric patients. Acta Psychiatrica Scandinavica 55, 299308.
Leese, M., Johnson, S., Slade, M., Parkman, S., Kelly, F., Phelan, M. & Thornicroft, G. (1998). User perspective on needs and satisfaction with mental health services. British Journal of Psychiatry 173, 409415.
Lehtinen, V., Joukamaa, M., Jyrkinen, E., Lathela, K., Raitasalo, R., Maatela, J. & Aromaa, A. (1990). Needs for mental health services of the adult population in Finland: results from the Mini Finland Survey. Acta Psychiatrica Scandinavica 81, 426431.
Leighton, D.C., Harding, J.S., Macklin, D.B., Hughes, C.C. & Leighton, A.H. (1963). The Character of Danger: Psychiatric Symptoms in Selected Communities. Basic Book: New York.
Lelliott, P., Jarman, B., Bajekal, M. & Glover, G. (1996). Commentaries on: an index of needs for psychiatric services based on in-patient utilisation. British Journal of Psychiatry 169, 317321.
Lesage, A.D., Mignolli, G., Faccincani, C. & Tansella, M. (1991a). Standardised assessment of the needs for care in a cohort of patients with schizophrenic psychoses. In Community-based Psychiatry: Long-term Patterns of Care in South-Verona (ed. Tansella, M.). Psychological Medicine Monograph Supplement 19. Cambridge University Press: Cambridge.
Lesage, A.D., Cope, S.J. & Pezeshgi, S. (1991b). Assessing the needs for care of non-psychotic patients. A trial with a new standardised procedure. Social Psychiatry and Psychiatric Epidemiology 26, 281286.
Lesage, A.D., Fournier, L., Cyr, M., Fabian, J., Gaudette, G., Vanier, C., Bebbington, P.E. & Brewin, C. (1996a). The reliability of the community version of the MCR Needs for Care Assessment. Psychological Medicine 26, 237243.
Lesage, A.D., Clerc, D., Uribe, I., Cournoyer, J., Fabian, J., Tourjman, V., van Haaster, I. & Chang, C.H. (1996b). Estimating local-area needs for psychiatric care: a case study. British Journal of Psychiatry 169, 4957.
Lewis, G. (1999). Population-based need assessment. Current Opinion in Psychiatry 12, 191194.
Lin, E., Goering, P.N., Lesage, A. & Streiner, D.L. (1997). Epidemiological assessment of overmet need in mental health care. Social Psychiatry and Psychiatric Epidemiology 32, 355362.
Liss, P. (1990). Health Care Need: Meaning and Measurement. Studies in art and Science: Link'ping.
Marriot, S., Malone, S., Onyett, S. & Tyrer, P. (1993). The consequences of an open referral system to a community mental health service. Acta Psychiatrica Scandinavica 88, 9397.
McCrone, P. & Strathdee, G. (1994). Needs not diagnosis: towards a more rational approach to community mental health resourcing in Britain. International Journal of Social Psychiatry 40, 7986.
Marshall, M., Hogg, L.I., Gath, D.H. & Lockwood, A. (1995). the Cardinal Needs Schedule a modified version of the MRC Needs for Care Assessment Schedule. Psychological Medicine 25, 605617.
Maslow, A. (1968). Towards a Psychology of Being, 2nd ed.D. van Nostrand: New York.
Matthew, G.K. (1971). Measuring need and evaluating services. In Portfolio for Health, Problems and Progress in Medical Care (ed. McLachlan, G.). Oxford University Press: London.
Middelboe, T., Mackeprang, T., Thalsgaard, A. & Christiansen, P.B. (1998). A housing support programme for the mentally ill: need profile and satisfaction among users. Acta Psychiatrica Scandinavica 98, 321327.
Millman, E.J. (1998). Midtown Manhattan prevalence rates and the implied need for treatment: meeting the challenge of public mental health. Archives of General Psychiatry 55, 11461148.
Mueser, K.T., Bellack, A.S., Wade, S.H., Sayers, S.T. & Rosenthal, C.K. (1992). An Assessment of the educational needs of chronic psychiatric patients and their relatives. British Journal of Psychiatry 160, 674680.
Murray, V., Walker, H.W., Mitchell, C. & Pelosi, A.J. (1996). Needs for care from demand led community psychiatric service: a study of patients with major mental illness. British Medical Journal 312, 15821586.
National Institute of Mental Health (1976). Abnormal involuntary movement scale. In ECDEU Assessment Manual (ed. Guy, W.). United States Department of Health, Education and Welfare: Rockville.
Norquist, T. & Wells, K. (1991). Mental health needs of the uninsured. Archives of General Psychiatry 48, 475478.
O'Leary, D. & Webb, M. (1996). The needs for care assessment n a longitudinal approach. Psychiatric Bulletin 20, 134136.
Olfson, M., Boadhead, E., Weissman, M.M., Leon, A.C., Farber, A.C., Hoven, C. & Kathol, R. (1996). Subthreshold psychiatric symptoms in a primary care group practice. Archives of General Psychiatry 53, 880886.
Phelan, M., Slade, M., Thornicroft, G., Dunn, G., Hollway, F., Wykes, T., Strathdee, G., Loftus, L., McCrone, P. & Hayward, P. (1995). The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry 167, 589595.
Phillips, J. (1997). Meeting the psychiatric needs of children in foster care. Social workers' view. Psychiatric Bulletin 21, 609611.
Pryce, I.G., Griffiths, R.D., Gentry, R.M., Hughes, I.C.T., Montague, L.R., Watkins, S.E., Champney-Smith, J. & McLackland, B.M. (1991). The nature and severity of disabilities in long-stay psychiatric in patients in South Glamorgan. British Journal of Psychiatry 158, 817821.
Pryce, I.G., Griffiths, R.D., Gentry, R.M., Hughes, I.C.T., Montague, L.R., Watkins, S.E., Champney-Smith, J. & McLackland, B.M. (1993). How important is the assessment of social skills in current long-stay inpatients? An evaluation of clinical response to needs for assessment, treatment, and care in a long-stay psychiatric in-patient population. British Journal of Psychiatry 162, 498502.
Rabinowitz, J., Gross, R. & Feldman, D. (1999). Correlates of a perceived needs for mental health assistance and differences between those who do and not seek help. Social Psychiatry and Psychiatric Epidemiology 34, 141146.
Ralston, G., Beesley, S. & Bogue, J. (1998). Users' needs and satisfaction with a community-based mental health service. Psychiatric Bulletin 22, 473476.
Randolph, F.L., Lindbenberg, R.E. & Menn, A.Z. (1986). Residential facilities for the mentally ill: needs assessment and community planning. Community Mental Health Journal 22, 7793.
Regier, D.A., Narrow, W.E., Rae, D.S., Mandersheid, R.W., Locke, B.Z. & Goodwin, F.K. (1993). The facto US mental and addictive disorders service system. Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry 50, 8594.
Robins, L.N., Helzer, J.E., Croughan, J. & Ratcliff, K.S. (1981). National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics and validity. Archives of General Psychiatry 38, 381388.
Rogler, L.H. & Cortes, D.E. (1993). Help-seeking pathways: a unifying concept in mental health care. American Journal of Psychiatry 150, 554561.
Rosenheck, R. & Lam, J.A. (1997). Homeless Mentally III Clients' and providers' Perceptions of Service Needs and Clients' Use of Services. Psychiatric Services 48, 381386.
Royse, D. & Drude, K. (1982). Mental health needs assessment: beware of false promises. Community Mental Health Journal 18, 97106.
Ruggeri, M. (1997). Service utilisation: a pivotal measure in assessing needs and service outcome. In Making rational mental health services (ed. Tansella, M.). Epidemiologia e Psichiatria Sociale Monograph Supplement 1, II Pensiero Scientifico Editore: Roma
Ruggeri, M., Lasalvia, A., Nicolaou, S. & Tansella, M. (1999). La versione italiana della Camberwell Assessment of Need (CAN), un'intervista per l'identificazione dei bisogni di cura. Epidemiologia e Psichiatria Sociale 8, 135167.
Ruggeri, M., Amaddeo, F. & Tansella, M. (2000). Assessing demand for care at the district level using a Psychiatric Case Register. In Measuring Mental Health Needs, 2nd ed. (ed. Thornicroft, G.). Gaskell: London.
Ruud, T., Martinsen, E.W. & Friis, S. (1998). Chronic patients in psychiatric institutions: psychopathology, level of functioning and need for care. Ada Psychiatrica Scandinavica 97, 5561.
Salokangas, R.K.R. (1994). Community care and need for treatment of schizophrenic patients in Finland. British Journal of Psychiatry, Suppl. 23, 115120.
Salokangas, R.K.R., Palo-oja, T., Ojanen, M. & Jalo, K. (1991a). Need for community care among psychotic outpatients. Acta Psychiatrica Scandinavica 84, 191196.
Salokangas, R.K.R., Palo-oja, T. & Ojanen, M. (1991b). The need for social support among out-patients suffering from functional psychosis. Psychological Medicine 21, 209217.
Shapiro, S., Skinner, E.A., Kramer, M., Steinwacs, D.M. & Regier, D.A. (1985). Measuring need for mental health services in a general population. Medical Care 23, 10331043.
Slade, M. (1994). Needs assessment: Involvement of staff and users will help to meet needs. British Journal of Psychiatry 165, 293296.
Slade, M. (1996). Assessing the needs of severely mentally ill: cultural and professional differences. International Journal of Social Psychiatry 42, 19.
Slade, M. & Thornicroft, G. (1995). Health and social needs of longterm mentally ill. Current Opinion in Psychiatry 8, 126129.
Slade, M., Phelan, M., Thornicroft, G. & Parkman, S. (1996). The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Social Psychiatry and Psychiatric Epidemiology 31, 109113.
Slade, M., Phelan, M. & Thornicroft, G. (1998). A comparison of needs assessed by staff and by an epidemiologically representative sample of patients with psychosis. Psychological Medicine 28, 543550.
Slade, M., Thornicroft, G., Loftus, L., Phelan, M. & Wykes, T. (1999).CAN: Camberwell Assessment of Need. A Comprehensive Needs Assessment Tool for People with Severe Mental Illness. Gaskell: London. (Ed. It.: CAN: Camberwell Assessment of Need. Uno strumento per la valutazione dei bisogni nei soggetti con disturbi mentali gravi, a cura di M. Ruggeri & M. Tansella, CIC Edizioni Internazionali: Roma, 2000).
Smith, P., Sheldon, T.A. & Martin, S. (1996). An index of need for psychiatric services based on in-patient utilisation. British Journal of Psychiatry 169,308316.
Spitzer, R.L. (1998). Diagnosis and need for treatment are not the same. Archives of General Psychiatry 55, 120.
Spitzer, R.L., Williams, J.B.W., Kroenke, K., Linzer, M., de Gruy, V.F., Brody, D., & Davies, M. (1994). Utility for a new procedure for diagnosing mental disorder in primary care. The PRIME-MD 1000 Study. Journal of the American Medical Association 272, 17491756.
Srole, L., Langner, T.S., Michael, S.T., Opler, M.K. & Ronnie, T.A.C. (1962). Mental Health in the Metropolis. The Mid-town Manhattan Study. McGrow-Hill: New York.
Stansfeld, S., Oriel, M., Mason, R., Nicholls, D. & D'Ath, P. (1998). A pilot study of needs assessment in acute psychiatric inpatients. Social Psychiatry and Psychiatric Epidemiology 33, 136139.
Stevens, A. & Gabbay, J. (1991). Needs assessment. Health Trends 23, 2023.
Stevens, A., Gooder, P. & Drey, N. (1998). Care needs of people with mental illness and aggression. Psychiatric Bulletin 22, 3641.
Stiffman, A.R., Chen, Y.W.Elze, D., Dore, P. & Cheng, L.C. (1997). Adolescents' and providers' perspectives on the need for and use of mental health services. Journal of Adolescent Health 21, 335342.
Tansella, M. & Micciolo, R. (1998). Unplanned first contact as predictor of future intensive use of mental health services. Social Psychiatry and Psychiatric Epidemiology 33,174180.
Tansella, M., Bisoffi, G. & Thornicroft, G. (1993). Are social deprivation and psychiatric service utilization associated in neurotic disorders? A case register study in South-Verona. Social Psychiatry and Psychiatric Epidemiology 28, 225230.
Thornicroft, G. (1991). Social deprivation and rates of treated mental disorders: developing statistical models to predict psychiatric service utilisation. British Journal of Psychiatry 158, 475484.
Thornicroft, G. (1993). Evaluating needs for care of psychiatric patients. Epidemiologia e Psichiatria Sociale 3, 167171.
Thornicroft, G (1996). The uses and limitations of mental health service needs indices. British Journal of Psychiatry 169, 792.
Thornicroft, G., De Salvia, D. & Tansella, M. (1993). Urban-rural differences in the association between social deprivation and psychiatric service utilisation in schizophrenia and all diagnoses: a case-register study in Northern Italy. Psychological Medicine 23, 487–469.
Trupin, E.W., Forsyth-Stevens, A. & Low, B.P. (1991). Service needs of severely disturbed children. American Journal of Public Health 81, 975980.
Uttaro, T. & Mechanic, D. (1994). The NAMI consumer survey analysis of unmet needs. Hospital and Community Psychiatry 45, 372374.
van Haaster, I., Lesage, A.D., Cyr, M. & Toupin, J. (1994a). Further reliability and validity studies of a procedure to assess the needs for care of the chronically mentally ill. Psychological Medicine 24,215222.
van Haaster, I., Lesage, A.D., Cyr, M. & Toupin, J. (1994b). Problems and needs for care of patients suffering from severe mental illness. Social Psychiatry and Psychiatric Epidemiology 29, 141148.
Waissman, L.C. & Rowland, L.A. (1989). Rankings of needs: a new method of assessment for use with chronic psychiatric patients. Acta Psychiatrica Scandinavica 80, 260266.
Wells, K.B., Stewart, A., Hays, R.D., Burnam, M.A., Rogers, W., Daniels, M., Berry, S, Greenfield, S. & Ware, J. (1989). The functioning and the well-being of depressed patients. Results from the Medical Outcome Study. Journal of the American Medical Association 262,914919.
Wiersma, D., Nienhuis, F.J., Giel, R., de Jong, A. & Slooff, C.J. (1996). Assessment of the need for care 15 years after onset of a Dutch cohort of patients with schizophrenia and an international comparison. Social Psychiatry and Psychiatric Epidemiology 31,114121.
Wiersma, D., Nienhuis, F.J., Giel, R., de Jong, A. & Slooff, C.J. (1998). Stability and change in needs of patients with schizophrenic disorders: a 15 and 17-year follow-up from first onset of psychosis, and a comparison between "objective" and "subjective" assessments of needs for care. Social Psychiatry and Psychiatric Epidemiology 33, 4956.
Wing, J.K., Cooper, J.E. & Sartorius, N. (1974). Measurement and Classification of Psychiatric Symptoms. An Instruction Manual for PSE and CATEGO Program. Cambridge University Press: London.
Wing, J.K. (1986). The cycle of planning and evaluation. In The Pro-vision of Mental Health Services in Britain: The Way-Ahead (ed. Wilkinson, G. & Freeman, H.). Gaskell: London.
Wing, J.K. (1990). Meeting the needs of people with psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology 25, 28.
Wing, J.K., Wing, L. & Hailey, A. (1970). The use of case registers for Supevaluating and planning psychiatric services. In Psychiatric Case Registers (ed. Wing, J.K., and Bransby, R.). HMSO: London.
World Health Organisation (1992). SCAN Schedule for Clinical Assessment in Neuropsychiatry. WHO: Geneva.
Wykes, T. & Sturt, E. (1986). The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry 148, 111.
Wykes, T., Creer, C. & Sturt, E. (1982). Needs and the deployment of services. In Long-term Community Care: Experience in a London Borough (ed. Wing, J.K.). Psychological Medicine Monograph Supevaluating plement 2. Cambridge University Press: Cambridge.
Wykes, T., Sturt, E. & Creer, C. (1985). The assessment of patients' needs for community care. Social Psychiatry 20, 7685.

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