Factors predicting early treatment discontinuation among depressed patients of working age in a psychiatric outpatient practice

Abstract

Depression is the greatest estimated cause of disability among people of working age. Preventing dropouts from depression treatment in the early stages of outpatient psychiatric care is important in avoiding poor outcomes. Since the long waiting time between appointment and consultation was one of the factors for dropout in previous studies, this study aimed to determine the early dropout rate and identify factors associated with early treatment discontinuation in depressed patients in a psychiatric outpatient practice, where immediate access to treatment is available. Of 563 participants, 184 (32.7%) stopped treatment within 1 month, which was as high as previous findings. Logistic regression analysis confirmed that younger age, ICD-10 F4 diagnosis, and lower attention-deficit/hyperactivity disorder (ADHD)-related characteristics predicted earlier treatment discontinuation. The current study suggests that immediate access to treatment might not significantly affect the rate of treatment discontinuation within 1 month for working-age depressed patients. Given the high rate of early treatment discontinuation, explaining the importance of continuing treatment might be necessary at the first visit, especially for patients with younger age, ICD-10 F4 diagnosis, and fewer complaints suggestive of ADHD.