Avaliação dos Motivos Subjacentes e Identificação de Fatores Preditivos do Drop-Out de Doentes Psiquiatricos

Abstract

The evaluation of psychiatric interventions results should be multidimensional, including clinical and social variables, such as individual experience of the mentally ill. The patient satisfaction with care has been recognized as an important variable, despite not being the main objective of the service or of the psychiatrist. However, if the user's perspective is not included, there's a risk of bias by the perception of the heath care providers. In this study, our aim was to understand if the abandonment of treatment (drop-out) represents an improvement or worsening of subjective well-being of patients and / or dissatisfaction with the services received, as well as to find predictors of drop-out. Identification of drop-outs in a 2-year cohort of patients who had initial psychiatric consultations in the Psychiatric Unit at Centro Hospitalar do Médio Ave - Unidade de Famalicão (Local Mental Health Service). We identified 512 patients who had a first psychiatric consultation, 57 of which unilaterally abandoned the treatment for at least six months, without making any contacts in order to reschedule the appointment during this period. Of these only 38 completed the assessment (telephone response to a semi-structured questionnaire). Three predictive factors for the drop-out were found: age, education and diagnosis. The reasons for treatment abandonment focused mainly in forgetfulness and dissatisfaction, the last one involving doctor-patient relationship issues. These results should be a starting point for assessing and improving care.