title: [Drop-out from a mental health centre after the first contact].
abstract: OBJECTIVE
  Many patients drop-out from treatment after a single contact; however, characteristics have only rarely been investigated. We aimed at estimating the frequency of early drop-out and identifying possible risk factors.
  
  
  METHODS
  The study was performed at the Palestrina Mental Health Centre, located near Rome, Italy. The clinical charts of all first-time attenders who did not come back during a 7-year index period (2000-2006) were reviewed and information was collected on sociodemographic factors, psychiatric history, clinical presentation, and process of care.
  
  
  RESULTS
  During the index period, 97 of 1.001 first-time attenders dropped out after the first contact. We excluded patients with symptoms of organic (N = 9) or severe mental disorders (N = 3). Of the remaining 85 patients, 49 presented with symptoms related to life events or situations ("reactive symptoms", RS), while 36 had "non-reactive symptoms" (NRS). Eighty-five randomly selected patients with comparable conditions (psychogenic reaction; anxiety, dysthymic or somatoform disorder; ICD-9 code 300.x, 308.x, 309.x) who came back to visit were included as controls. First-only contact patients tended to present with RS more often (58% vs. 43%) than controls. Therefore, the analyses were stratified for reactivity of symptoms. Among patients with NRS, first-only contact patients tended to be younger than controls. Among patients with RS, time until the next appointment tended to be longer in first-only contact patients than in controls. No other differences were observed between first-only contact patients and controls on sociodemographic variables, source of referral, and previous treatment history.
  
  
  CONCLUSIONS
  The occurrence of early drop-out was relatively low. The higher prevalence of RS among first-only contact patients may suggest a greater disposition towards conflict or ambivalence in interpersonal situations. Patient-perceived service availability, in the form of shorter appointment delay, seems to promote maintenance of contact. Younger patients who tend to be at higher risk of early drop-out deserve increased clinical attention.
authors.affiliation: Centro di Salute Mentale, ASL RM/G Palestrina, RM.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palmieri
authors.forename: Carlo
authors.initials: C
authors.lastname: D'Amore
authors.forename: Rita
authors.initials: R
authors.lastname: Cecchetti
authors.forename: Nadia
authors.initials: N
authors.lastname: Bonamoneta
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Gonnella
authors.forename: Margherita
authors.initials: M
authors.lastname: Moio
authors.forename: Stefania
authors.initials: S
authors.lastname: Paoletti
authors.forename: Stefania
authors.initials: S
authors.lastname: Vendetti
authors.forename: Rita
authors.initials: R
authors.lastname: Schiavella
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D010352:Patient Dropouts / Q000706:statistics & numerical data*