Personality and psychopathology correlates of dropout in an outpatient psychiatric service.

AIM

The dropout from care in public psychiatric units is a frequent event and strategies to reduce its incidence are still debated. This study aims to determine which personality and psychopathology dimensions influence the dropout in a psychiatric unit.

METHODS

All new patients referred to a public psychiatric outpatient service were tested with self-administered inventories assessing personality traits (TCI), parental bonding (PBI), and psychopathology (SCL-90; BDI; STAXI). Completers were divided into nondropout, late dropout, and early dropout groups which were compared with each other with respect to diagnosis, referral, demographic data and the inventories. Logistic regression was performed between dropout and non dropout subjects with respect to the significantly differing variables.

RESULTS

No clinical or demographic characteristic predict dropout. Numerous SCL-90 psychopathology scales, state anger and some TCI personality facets distinguish dropout from in care subjects. Psychoticism and sentimentalism have been evidenced independent predictors of dropout.

CONCLUSION

In the present study dropout from the psychiatric unit is more related to personal characteristics than to sociodemographic variables or diagnosis. Dropout is related to personality and psychopathology characteristics which may reduce subject's relational skills and impair therapeutic alliance. These traits may also influence subjects' perception of the service quality and of the assessment procedure. The acknowledgement of such traits as possible determinants of dropout may orient service organization and personnel education to prevent this phenomenon in health care services. Strategies for preventing dropout are discussed.