Cornelissen A T J, Poppe E, Ouwens M A
Tijdschr Psychiatr. 2010;52(1):17-27.
Drop-out is a serious problem in psychotherapy. Earlier studies have shown that the main factors associated with drop-out are young age, low socio-economic status and pathological symptoms such as severity of the problems and problematic substance-abuse.
To investigate patient's and pathological characteristics that predict drop-out among patients with predominantly personality problems.
Patient's characteristics and pathological characteristics of 372 subjects were ascertained via a retrospective study by means of four databases: intake letters, scid-ii personality questionnaires, scid-i and ii interviews and discharge letters. The association between these characteristics and drop-out was tested by means of bivariate and multivariate analysis. results The drop-out rate was 33.3 %. The main predictors of drop-out were young age, a low Global Assessment of Functioning (gaf)-score and the existence of problematic substance-abuse at discharge. The degree and severity of axis i disorders and the nature of personality problems made hardly any contribution to the prediction of drop-out.
These findings indicate that more attention needs to be given to the existence of substance-abuse before psychotherapy begins. Drop-out is still a problem and is difficult to predict and hard to influence.
在心理治疗中,脱落是一个严重的问题。早期研究表明,与脱落相关的主要因素包括年龄小、社会经济地位低以及病理症状,如问题的严重程度和有问题的药物滥用。
调查主要存在人格问题的患者中预测脱落的患者及病理特征。
通过回顾性研究,借助四个数据库确定了372名受试者的患者特征和病理特征,这四个数据库分别为:入院信、SCID-II人格问卷、SCID-I和II访谈以及出院信。通过双变量和多变量分析测试了这些特征与脱落之间的关联。结果脱落率为33.3%。脱落的主要预测因素是年龄小、功能总体评定量表(GAF)得分低以及出院时存在有问题的药物滥用。轴I障碍的程度和严重程度以及人格问题的性质对脱落预测几乎没有贡献。
这些发现表明,在心理治疗开始前需要更多关注药物滥用的存在。脱落仍然是一个问题,难以预测且难以影响。