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| |  Attrition During Therapy Can Be Predicted by Patient Variables: Presented at EPA By Jenny Powers MUNICH, Germany -- March 5, 2010 -- Clinical factors are largely responsible for the failure of a patient to begin offered therapy (no-show) and socioeconomic factors influence whether a patient who has initiated treatment will complete the course or drop out, according to a study presented here on March 1 at the European Psychiatric Association (EPA) 18th European Congress of Psychiatry. Morten Fenger, Psychotherapeutic Center Stolpegaard, Mental Health Services, Copenhagen, Denmark, presented study results on behalf of a team of Danish investigators who sought to determine the causes for nonattendance in mental health treatment and to identify predictors for this behaviour that poses economic problems for the healthcare system and may result in deterioration of the patients’ condition. The study’s objective was to determine the influence of demographic and clinical variables on treatment attendance. A total of 2,474 nonpsychotic consecutive patients were offered psychotherapeutic treatment from April 2004 to April 2005 at the Psychotherapeutic Center Stolpegaard. Demographic and clinical variables were registered at assessment. Bivariate and multiple logistic regression analyses of the associations between these variables and attendance were conducted. The following group definitions were used: No-shows were patients who do not attend the first treatment session and neither cancelled nor sought to reschedule; dropouts were patients who attended at least 1 session but not more than 6 subsequent sessions and who terminated without therapist agreement; and completers were those patients who completed their treatment according to their therapist’s recommendations. Of the patients, 675 (27.3%) did not show up and 289 (11.7%) dropped out of treatment. Regression analysis identified 9 significant predictors for nonattendance; younger age, fewer years of school, taking an education, unemployment, no sick leave, personality disorder, low or high GAF, no earlier treatment, no use of psychoactive medicine, and substance abuse. These variables indicated a correct classification in 76.3% of the cases. Regarding dropouts, 7 variables were identified as predictors including younger age, having a partner, being single, up to 9 years of school, taking an education, unemployment, and substance abuse. These variables indicated a correct classification in 84.1% of the cases. In all, 11 socioeconomic and clinical variables were found to be effective predictors of patient attrition in treatment. The main factors in no-show behaviour were both demographic and clinical whereas only socioeconomic factors indicated dropouts. The abuse of alcohol or drugs was a predictive variable in both no-show and dropout behaviour. Mental illness itself prevents the patients from showing up for initial treatment but if the patient begins treatment the likelihood of completion is impacted by the socioeconomic status. Funding for this study was provided by TrygFonden. [Presentation title: No-Shows, Drop-Outs and Completers in Psychotherapeutic Treatment: Demographic and Clinical Predictors in a Large Sample of Non-Psychotic Patients. Abstract PW01-122]
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