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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

  • Alejandra Pinto-Meza
  • Anna Fernández
  • Ronny Bruffaerts
  • Jordi Alonso
  • Viviane Kovess
  • Ron De Graaf
  • Giovanni de Girolamo
  • Herbert Matschinger
  • Josep M. Haro
Original Paper

Abstract

Purpose

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.

Keywords

Dropout Epidemiology Mental disorders Psychiatrists General practitioners 

Notes

Acknowledgments

The survey discussed in this article was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. We thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/.

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Alejandra Pinto-Meza
    • 1
  • Anna Fernández
    • 1
  • Ronny Bruffaerts
    • 2
  • Jordi Alonso
    • 3
  • Viviane Kovess
    • 4
  • Ron De Graaf
    • 5
  • Giovanni de Girolamo
    • 6
  • Herbert Matschinger
    • 7
  • Josep M. Haro
    • 1
  1. 1.Parc Sanitari Sant Joan de DeuBarcelonaSpain
  2. 2.Department of Neurosciences and PsychiatryUniversity Hospital GasthuisbergLeuvenBelgium
  3. 3.Health Services Research Unit, Institut Municipal d’ Investigació Mèdica (IMIM-Hospital del Mar)BarcelonaSpain
  4. 4.Department of EpidemiologyEA 4069 Paris Descartes University, EHESP (School of Public Health)ParisFrance
  5. 5.Netherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
  6. 6.IRCCS Centro S. Giovanni di Dio-FatebenefratelliBresciaItaly
  7. 7.Psychiatry DepartmentUniversity of LeipzigLeipzigGermany

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