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Determinants of dropout in a community-based mental health crisis centre

Overview of attention for article published in BMC Psychiatry, April 2016
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Determinants of dropout in a community-based mental health crisis centre
Published in
BMC Psychiatry, April 2016
DOI 10.1186/s12888-016-0819-4
Pubmed ID

Alexandre Henzen, Clotilde Moeglin, Panteleimon Giannakopoulos, Othman Sentissi


Dropping out during the course of medical follow up is defined as an early therapy withdrawal without the agreement of the therapist. In a psychiatric crisis unit in Geneva, we empirically observed that almost 50 % of the patients were not showing up to their first appointments, which were scheduled for 3 to 7 days post discharge. The aim of this naturalistic descriptive cohort study is to identify the demographic, patient and care-related predictive factors of dropout in a community-based psychiatric crisis centre. We included 245 consecutive outpatients followed-up for 4 to 6 weeks of intensive outpatient psychiatric treatment. Logistic regression models were built to examine the association between dropout and demographic, care and patient-related variables. Among the 245 outpatients, dropout occurred in 37.5 % of cases, and it most frequently occurred (81.8 %) in the first 2 days of follow-up. Among care-related variables, referral by hospital units or private psychiatrists led to significantly lower levels of dropout compared to patients referred by the psychiatric emergency unit (respectively: OR = .32; p = .04; 95 % CI [.10, .93]; OR = .36; p = .04; 95 % CI [.13, .96]; OR = .22; p = .002; 95 % CI [.08, .58]). Among patient-related variables, younger age increased the risk of dropout (OR = .96; 95 %; p = .002; 95 % CI [.94, .99]). Anxiety and personality but not mood disorders were also related to higher rates of dropout (respectively: OR = 2.40; p = .02; 95 % CI [1.14, 4.99]; and OR = 1.98; p = .02; 95 % CI [1.09, 3.59]). Unipolar depression (72.2 %; OR = 1.47; p = .48; 95 % CI [.34, 1.21]) was the most frequent primary diagnosis in this sample. This study makes clear the need for increased efforts to improve care adherence in young patients with anxious or personality disorders seen in emergency rooms because they are prone to early discontinuation of treatments. Future studies in this field are warranted to gain a better understanding into the complex reasons that surround discontinuation of care in outpatient settings.

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Mendeley readers

The data shown below were compiled from readership statistics for 78 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Australia 1 1%
Unknown 77 99%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 12 15%
Student > Bachelor 10 13%
Student > Doctoral Student 7 9%
Student > Master 6 8%
Researcher 5 6%
Other 19 24%
Unknown 19 24%
Readers by discipline Count As %
Psychology 25 32%
Medicine and Dentistry 21 27%
Nursing and Health Professions 4 5%
Neuroscience 3 4%
Computer Science 1 1%
Other 5 6%
Unknown 19 24%

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