Serious Mental Illness Treatment Research and Evaluation Center, North Campus Research Complex, 2800 Plymouth Rd, Building 10 6016, Ann Arbor, MI, 48109-2800, USA,
Community Ment Health J. 2013 Dec;49(6):694-703. doi: 10.1007/s10597-012-9544-8. Epub 2012 Oct 21.
Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed.
精神科住院患者出院后不再接受门诊治疗的情况较为常见，这会导致他们更多地使用重症监护服务。为了研究与治疗中断相关的变量，我们从接受住院精神科服务的 233 名退伍军人那里收集了一系列人口统计学、诊断、认知、社会和行为变量，然后在接下来的 2 年内对他们进行监测。在随访期间，88.0%（n=202）的患者不再接受住院后的治疗。中断治疗与男性、年龄较小、增加对耻辱感的预期、较少短期参加团体治疗以及较差的药物依从性有关。在那些离开治疗的患者中，更早的中断治疗与前一年的住院精神科天数较少、一生中的精神病院住院次数较少、来自家庭的治疗支持增加以及短期看诊次数较少有关。我们使用生存分析来分析整个样本以及短期参加团体治疗的样本的中断率。讨论了相关意义。
