Dropping out of mental health treatment among patients with depression and anxiety by type of provider: results of the European Study of the Epidemiology of Mental Disorders.
OBJECTIVE
Dropping out from mental health treatment is a major problem because mental health treatments delivered for inadequate durations are ineffective. The aim of this study was to compare treatment dropout rates by type of provider, dropout risk by number of visit, and to ascertain factors associated with treatment dropout.


METHODS
A cross-sectional household survey of a representative sample of 626 out of 21,425 non-institutionalized adults from the general population of six European countries was carried out. Dropout was defined as terminating treatment before recommendation.


RESULTS
Dropout from all treating providers during a 12-month period was 14%. Among psychiatrists, psychologists, and general practitioners figures were: 19.6, 20.3, and 20.3%, respectively. While the hazard risk for dropping out was higher during the first three visits to GPs and psychologists, it was stable for psychiatrists. Older age, female gender, and living in large or midsize urban areas were associated with a decreased risk of dropping out.


CONCLUSIONS
Efforts for increasing patients' proportion completing adequate courses of care for mental disorders in Europe should focus on the first visits, especially those made to the general medical care.
Pinto-Meza
Alejandra
A
Parc Sanitari Sant Joan de Deu, Barcelona, Spain. apinto@pssjd.org
Fernández
Anna
A
Bruffaerts
Ronny
R
Alonso
Jordi
J
Kovess
Viviane
V
De Graaf
Ron
R
de Girolamo
Giovanni
G
Matschinger
Herbert
H
Haro
Josep M
JM
D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000628:therapy*; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D058005:General Practitioners; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000706:statistics & numerical data; D011584:Psychology / Q000706:statistics & numerical data