[Dropout behavior in inpatient psychosomatic rehabilitation: how and when do inpatients terminate psychotherapy?]

Despite its clinical and health economic importance, only few studies have analyzed the problem of dropout behavior from treatment in psychosomatic medicine and psychotherapy. For quality-assurance purposes and in light of limited resources in our medical system, it is important to identify future dropouts and to intervene appropriately during ongoing inpatient treatment. In a representative sample taken from inpatient psychosomatic rehabilitation, we evaluated the prevalence of dropout behavior as well as characteristics of patients who drop out compared to patients who complete the treatment regularly.

Data of 2059 inpatients from the Psychosomatic Hospital Bad Neustadt/Saale were analyzed as to rates and dates of dropout and other patient characteristics.

Overall 15.7 % of the patients dropped out of inpatient psychosomatic rehabilitation after a mean treatment duration of 28 days. Patients who dropped out tended to be younger, reported less distress, were less motivated, and had been diagnosed less often with an affective disorder as main diagnosis. Compared with patients who completed therapy regularly, they also profited less from both self- as well as external assessment of symptom change. It was shown that it is useful to differentiate the method and time of dropout.

A differentiation of dropout characteristics is important for developing interventions to reduce dropout rates.