title: 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.
abstract: 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.
authors.affiliation: Parc Sanitari Sant Joan de Deu, Barcelona, Spain. apinto@pssjd.org
authors.forename: Alejandra
authors.initials: A
authors.lastname: Pinto-Meza
authors.forename: Anna
authors.initials: A
authors.lastname: Fernández
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess
authors.forename: Ron
authors.initials: R
authors.lastname: De Graaf
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Herbert
authors.initials: H
authors.lastname: Matschinger
authors.forename: Josep M
authors.initials: JM
authors.lastname: Haro
mesh_terms: 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