Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands.
Compr Psychiatry. 2012 Jan;53(1):63-70. doi: 10.1016/j.comppsych.2011.01.011. Epub 2011 Mar 11.
Although attrition is inevitable in longitudinal epidemiological studies, psychiatric studies are thought to be especially sensitive to attrition. This study aimed to evaluate the sociodemographic and psychiatric determinants of attrition at 2-year follow-up in the Netherlands Study of Depression and Anxiety.
Logistic regression was used to examine sociodemographic and psychiatric determinants of attrition and the influence of clinical psychiatric characteristics on attrition. In addition, differences in determinants between 3 types of attrition (refusal, noncontact, and not able to participate) were evaluated.
The attrition rate at the 2-year follow-up assessment was 12.9% (385/2981), representing 6 deceased persons, 250 refusers, 51 noncontacts, and 78 persons unable to participate because of health reasons. Determinants of attrition were younger age, less years of education, not being of North European descent, being recruited in Amsterdam, no previous participation in research, and having major depressive disorder. Only the effects of age, sampling site, and previous participation in research differed between types of attrition. Furthermore, comorbid depressive and anxiety disorders and higher symptom severity were associated with attrition.
In contrast to the view that psychiatric epidemiological research is more prone to high attrition rates, this study revealed a relatively low attrition rate. Furthermore, both sociodemographic and psychiatric variables were independent determinants of attrition. Oversampling of subgroups that are at higher risk of dropout may be advisable for future psychiatric cohort studies.
尽管在纵向流行病学研究中不可避免会出现流失现象,但人们认为精神病学研究尤其容易受到流失的影响。本研究旨在评估荷兰抑郁和焦虑研究中 2 年随访时流失的社会人口学和精神病理学决定因素。
使用逻辑回归来检验流失的社会人口学和精神病理学决定因素,以及临床精神病理学特征对流失的影响。此外,还评估了 3 种流失类型(拒绝、无联系和无法参与)之间决定因素的差异。
在 2 年随访评估时的流失率为 12.9%(385/2981),包括 6 名死亡者、250 名拒绝者、51 名无联系者和 78 名因健康原因无法参加者。流失的决定因素为年龄较小、受教育年限较短、非北欧血统、在阿姆斯特丹招募、以前没有参与过研究以及患有重度抑郁症。仅年龄、采样地点和以前参与研究的影响在不同的流失类型之间存在差异。此外,共患抑郁和焦虑障碍以及更高的症状严重程度与流失有关。
与精神病流行病学研究更容易出现高流失率的观点相反,本研究显示出相对较低的流失率。此外,社会人口学和精神病理学变量都是流失的独立决定因素。对于未来的精神病队列研究,可能需要对流失风险较高的亚组进行超额抽样。