ArticleBMC health services research2021
Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Cognitive behavioural therapy and third-wave approaches for anxiety and related disorders in older people.The Cochrane database of systematic reviews · 2024Pooled it
- Is ageism among prescribers an influential factor in the management of depression in the elderly? A vignette-based study.Family practice · 2026Article
- Outpatient psychotherapeutic treatment of gambling disorder - lessons learned from Bavaria.Frontiers in psychiatry · 2026Article
- Barriers to accessing psychotherapeutic care among young adults: Individual and regional associated factors.Journal of health monitoring · 2025Article
- Quantifying age-related disparities in outpatient psychotherapy utilization: a representation quotient analysis of routine data from 29 university clinics in Germany.BMC health services research · 2025Article
- Assessing Perceived Need for Mental Healthcare Among Adults in Germany.International journal of public health · 2025Article
- Attitudes towards seeking psychological help among community dwelling older adults enrolled in primary care in Chile.BMC geriatrics · 2024Article
- Do values and political attitudes affect help-seeking? Exploring reported help-seeking for mental health problems in a general population sample using a milieu framework.Epidemiology and psychiatric sciences · 2023Article
- Middle-aged and older people with urgent, unaware, and unmet mental health care needs: Practitioners' viewpoints from outside the formal mental health care system.BMC health services research · 2022Article
- Depression in primary care and the role of evidence-based guidelines: cross-sectional data from primary care physicians in Germany.BMC health services research · 2022Article
- Socioeconomic factors and use of psychotherapy in common mental disorders predisposing to disability pension.BMC health services research · 2022Article
- To which non-physician health professionals do French general practitioners refer their patients to and what factors are associated with these referrals? Secondary analysis of the French national cross-sectional ECOGEN study.BMC health services research · 2022Observational
- Evidence-oriented teaching of geriatric psychiatry: a narrative literature synthesis and pilot evaluation of a clerkship seminar.GMS journal for medical education · 2022Review
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
beackgroundOlder adults with mental health problems may benefit from psychotherapy; however, their perceived need for treatment in relation to rates of non-utilization of outpatient psychotherapy as well as the predisposing, enabling, and need factors proposed by Andersen's Model of Health Care Utilization that account for these differences warrant further investigation.
methodsWe used two separate cohorts (2014 and 2019) of a weighted nationwide telephone survey in Germany of German-speaking adults with N = 12,197 participants. Across the two cohorts, 12.9% (weighted) reported a perceived need for treatment for mental health problems and were selected for further analyses. Logistic Generalized Estimation Equations (GEE) was applied to model the associations between disposing (age, gender, single habiting, rural residency, general health status), enabling (education, general practitioner visit) non-utilization of psychotherapy (outcome) across cohorts in those with a need for treatment (need factor).
resultsIn 2014, 11.8% of 6087 participants reported a perceived need for treatment due to mental health problems. In 2016, the prevalence increased significantly to 14.0% of 6110 participants. Of those who reported a perceived need for treatment, 36.4% in 2014 and 36.9%in 2019 did not see a psychotherapist - where rates of non-utilization of psychotherapy were vastly higher in the oldest age category (59.3/52.5%; 75+) than in the youngest (29.1/10.7%; aged 18-25). Concerning factors associated with non-utilization, multivariate findings indicated participation in the cohort of 2014 (OR 0.94), older age (55-64 OR 1.02, 65-74 OR 1.47, 75+ OR 4.76), male gender (OR 0.83), lower educational status (OR 0.84), rural residency (OR 1.38), single habiting (OR 1.37), and seeing a GP (OR 1.39) to be related with non-utilization of psychotherapy; general health status was not significantly associated with non-utilization when GP contact was included in the model.
conclusionThere is a strong age effect in terms of non-utilization of outpatient psychotherapy. Individual characteristics of both healthcare professionals and patients and structural barriers may add to this picture. Effective strategies to increase psychotherapy rates in those older adults with unmet treatment needs are required.
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