Acknowledging illness and treatment needs in first-time admitted psychiatric patients

Help-seeking and service utilization depends on the patients' interpretation of their illness and treatment needs. Worry, denial of illness, need for treatment and need for hospitalization in first-time admitted patients was studied.

New patients in two mental hospitals were consecutively recruited. Three hundred and thirty-four satisfied the inclusion criteria and 251 gave informed consent. One hundred and ninety-six had complete datasets (56% of those eligible).

Demography was recorded with the Minimal Basic Dataset by Ruud et al. (1993). Experiences of hospitalisation were measured with the Patient's Experience of Hospitalisation Questionnaire by Carskey et al. (1992). MINI was used for diagnosing and SCL-90-R by Derogatis (1997) for subjective symptoms. Standard multiple regressions were performed with the PEH subscales (Denial, Worry, Need for treatment and Need for hospitalisation) as dependents and demography, diagnosis and SCL-90-R subscales as explanatory variables.

(a) Psychoticism and the diagnosis of schizophrenia were associated with little worrying, denial of illness, of treatment needs and of need for hospitalisation. (b) Anxiety and affective disorders were related to worries, acknowledgement of illness, need for treatment and for hospitalisation.

In contrast to patients with mainly anxiety and affective disorders, psychotic patient tended to deny illness-related worries, that they had an illness and that they needed treatment and hospitalisation. An affective disorder together with suicidal thoughts (not attempts) was a strong drive towards hospital admission.