Abstract
AbstractEfficacious treatments are available for major depressive disorder (MDD), but treatment dropout is common and decreases their effectiveness. However, knowledge about prevalence of treatment dropout and its risk factors in routine care is limited. The objective of this study was to determine the prevalence of and risk factors for dropout in a large outpatient sample. In this retrospective cohort analysis, routinely collected data from 2235 outpatients with MDD who had a diagnostic work-up between 2014 and 2016 were examined. Dropout was defined as treatment termination without achieving remission before the fourth session within six months after its start. Total and item scores on the Dutch Measure for Quantification of Treatment Resistance in Depression (DM-TRD) at baseline, and demographic variables were analyzed for their association with dropout using logistic regression and elastic net analyses. Data of 987 subjects who started routine outpatient depression treatment were included in the analyses of which 143 (14.5%) dropped out. Higher DM-TRD-scores were predictive for lower dropout odds [OR = 0.78, 95% CI = (0.70–0.86), p < 0.001]. The elastic net analysis revealed several clinical variables predictive for dropout. Higher SES, higher depression severity, comorbid personality pathology and a comorbid anxiety disorder were significantly associated with less dropout in the sample. In this observational study, treatment dropout was relatively low. The DM-TRD, an easy-to-use clinical instrument, revealed several variables associated with less dropout. When applied in daily practice and combined with demographical information, this instrument may help to reduce dropout and increase treatment effectiveness.
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Biological Psychiatry,Psychiatry and Mental health,General Medicine
Reference68 articles.
1. Cahill J, Barkham M, Hardy G, Rees A, Shapiro DA, Stiles WB, Macaskill N (2003) Outcomes of patients completing and not completing cognitive therapy for depression. Br J Clin Psychol 42(2):133–143
2. Garfield SL (1994) Research on client variables in psychotherapy. Handbook of psychotherapy and behavior change, 4th edn. John Wiley & Sons, Oxford, pp 190–228
3. Klein EB, Stone WN, Hicks MW, Pritchard IL (2003) Understanding dropouts. J Ment Health Couns 25(2):89–100
4. Piselli A, Halgin RP, MacEwan GH (2011) What went wrong? Therapists’ reflections on their role in premature termination. Psychother Res 21(4):400–415
5. Barrett MS, Chua W-J, Crits-Christoph P, Gibbons MB (2008) Thompson D (2008) Early withdrawal from mental health treatment: Implications for psychotherapy practice. Psychotherapy 45(2):247
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