Prospective controlled study of psychiatric out-patient non-attendance. Characteristics and outcome.
BACKGROUND
Psychiatric clinics have high non-attendance rates and failure to attend may be a sign of deteriorating mental health.


OBJECTIVE
To investigate why psychiatric out-patients fail to attend, and the outcome of attenders and non-attenders.


METHODS
Prospective cohort study of randomly selected attenders and non-attenders at general adult psychiatric out-patient clinics. Subjects were interviewed at recruitment and severity of mental disorder and degree of social adjustment were measured. Six and 12 months later their engagement with the clinic and any psychiatric admissions were ascertained.


RESULTS
Of the 365 patients included in the study, 30 were untraceable and 224 consented to participate. Follow-up patients were more psychiatrically unwell than new patients. For follow-up patients, non-attenders had lower social functioning and more severe mental disorder than those who attended. At 12-month follow-up patients who missed their appointment were more likely to have been admitted than those who attended.


CONCLUSIONS
Those who miss psychiatric follow-up out-patient appointments are more unwell and more poorly socially functioning than those who attend. They have a greater chance of drop-out from clinic contact and subsequent admission.
Killaspy
H
H
Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London.
Banerjee
S
S
King
M
M
Lloyd
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000469:parasitology* / Q000628:therapy; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012944:Social Support; D016312:Treatment Refusal