Department of Child Health, Behavior and Development, Seattle Children's Research Center, Seattle, WA, USA.
Faculty of Health, School of Psychology, Deakin University, Melbourne, Australia.
J Anxiety Disord. 2017 Dec;52:25-33. doi: 10.1016/j.janxdis.2017.10.001. Epub 2017 Oct 6.
Despite being a relatively prevalent and debilitating disorder, Generalized Anxiety Disorder (GAD) is the second least studied anxiety disorder and among the most difficult to treat. Dropout from psychotherapy is concerning as it is associated with poorer outcomes, leads to service inefficiencies and can disproportionately affect disadvantaged populations. No study to date has calculated a weighted mean dropout rate for GAD and explored associated correlates.
A systematic review was conducted using PsycINFO, Medline and Embase databases, identifying studies investigating individual psychotherapies for adults with GAD. Forty-five studies, involving 2224 participants, were identified for meta-analysis.
The weighted mean dropout rate was 16.99% (95% confidence interval 14.42%-19.91%). The Q-statistic indicated significant heterogeneity among studies. Moderator analysis and meta-regressions indicated no statistically significant effect of client age, sex, symptom severity, comorbidity, treatment type, study type (randomized trial or not), study quality, number of sessions or therapist experience.
In research investigating psychotherapy for GAD, approximately one in six clients can be expected to drop out of treatment. Dropout rate was not significantly moderated by the client, therapist or treatment variables investigated. Future research should specify the definition of dropout, reasons for dropout and associated correlates to assist the field's progression.
尽管广泛性焦虑症（GAD）是一种相对普遍且使人虚弱的疾病，但它是研究最少的焦虑症之一，也是最难治疗的焦虑症之一。从心理治疗中辍学令人担忧，因为它与较差的结果相关，导致服务效率低下，并且可能不成比例地影响弱势群体。迄今为止，没有研究计算过 GAD 的加权平均辍学率，并探讨了相关的相关性。
使用 PsycINFO、Medline 和 Embase 数据库进行系统评价，确定了针对患有 GAD 的成年人的个体心理治疗的研究。共确定了 45 项研究，涉及 2224 名参与者进行荟萃分析。
加权平均辍学率为 16.99%（95%置信区间 14.42%-19.91%）。Q 统计量表明研究之间存在显著异质性。 调节分析和元回归表明，客户年龄、性别、症状严重程度、合并症、治疗类型、研究类型（随机试验或非随机试验）、研究质量、治疗次数或治疗师经验等客户、治疗师或治疗变量均无统计学意义。
在研究 GAD 的心理治疗中，预计约六分之一的客户会中途退出治疗。辍学率没有被客户、治疗师或治疗变量显著调节。未来的研究应该具体说明辍学的定义、辍学的原因以及相关的相关性，以帮助该领域的发展。
