Use of community support services by middle-aged and older patients with psychotic disorders

Objective: The study sought to determine the degree to which use of communi ty services is related to predisposing, enabling, and need factors among ol der patients with psychotic disorders who live in the community and to asse ss whether high use of community services is associated with improving or d eclining psychopathology. Methods: The sample consisted of 89 middle-aged a nd elderly community-dwelling patients with schizophrenia or other psychoti c disorders. Assessments at baseline and two follow-ups at six-month interv als adjusted measures of psychopathology, well-being, and social adjustment , in addition to the frequency of use of 17 formal community services in th ree categories-psychological, social, and daily living services. Results: N inety-two percent of patients reported use of community support services. T he mean number of annual service contacts per patient was 36.6 for psycholo gical services, 81 for social services, and 39.7 for daily living services. High users of psychological services were younger and experienced more sev ere positive psychotic symptoms and depressive symptoms. High users of soci al services were of higher socioeconomic status, more likely to be female, and had a longer history of psychosis, more cognitive deficits, and more se vere negative psychotic and depressive symptoms. Patients who used daily li ving services were older, had poorer functional health status and more cogn itive deficits, and Bad more severe negative psychotic and depressive sympt oms. A trend was noted for high users of social services to experience reli ef from depressive symptoms over time. Conclusions: Use of community servic es is common among older outpatients with psychotic disorders, but its freq uency varies as a function of patient characteristics.