Psychiatric Quarterly

, Volume 85, Issue 4, pp 467–477 | Cite as

Seasonality, Smoking and History of Poor Treatment Compliance are Strong Predictors of Dropout in a Naturalistic 6 Year Follow-Up of Bipolar Patients

  • Elena Ezquiaga
  • Aurelio García-López
  • Consuelo de Dios
  • Jose Luis Agud
  • David Albillo
  • Lorena Vega-Piris
Original Paper
First Online:

Abstract

Bipolar disorder is a highly recurrent disease which requires long-term treatment. Dropout is a major problem, poorly understood. The objectives of this study were to know the risk of dropout of a cohort of bipolar patients under ambulatory treatment and to identify the clinical profile of patients more likely to abandon the follow-up. A sample of 285 BD I and II patients was followed up for a mean of 2.87 years. A significant proportion of patients failed regular follow-up. The dropout rates were 6.3 % at three months, 12.7 % at 6 months, and 17.6, 27.2, 37.3, 44.0, 47.2 and 49.0 % at 1, 2, 3, 4, 5 and 6 years respectively. Very few variables at baseline predicted dropout. Patients under 35 years of age were more likely to dropout than older cases. Seasonality, smoking and specially history of poor treatment compliance were strong predictors of dropout. Given the magnitude of dropout, additional early clinical interventions should be considered for high-risk patients.

Keywords

Bipolar disorder Dropout Smoking Seasonality Compliance 
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Notes

Acknowldgments

We would like to thank to our patients. We would like to thank Dr. Ana de Leiva for helping us to review this paper. This study was supported by Lundbeck Pharmaceuticals, only for adapting the initial data collection instrument into a database instrument compatible with usual statistical packages. Lundbeck did not have any role in the study design, in the collection, analysis and interpretation of data, in writing the report, nor in the decision to submit the paper for publication.

Conflict of interest

Dr. Ezquiaga has served as speaker for the following entities: Boehringer-Ingelheim, Lundbeck, Rovi and Servier, Dr. García-López has served as speaker for the following entities: Lundbeck, Pfizer, Servier, Dr. C. de Dios has received grant support or given presentations for the following pharmaceutical companies: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen-Cilag, Pfizer, Glaxo-Smithkline, Lundbeck, Sanofi-Aventis, and Boehringer-Ingelheim. Dr. Agud has served as speaker for Bristol-Myers-Otsuka and Lilly. Lorena Vega Piris and Dr. Albillo declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Elena Ezquiaga
    • 1
  • Aurelio García-López
    • 2
  • Consuelo de Dios
    • 3
  • Jose Luis Agud
    • 4
  • David Albillo
    • 5
  • Lorena Vega-Piris
    • 6
  1. 1.University Hospital La Princesa, Universidad Autónoma de MadridMadridSpain
  2. 2.Mental Health Centre San BlasUniversity Hospital Ramón y CajalMadridSpain
  3. 3.Mental Health Centre FuencarralUniversity Hospital La PazMadridSpain
  4. 4.University Hospital Severo OchoaMadridSpain
  5. 5.University Hospital La PrincesaMadridSpain
  6. 6.Institute for Health ResearchUniversity Hospital La PrincesaMadridSpain

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