Dropping out of psychiatric treatment: a methodological contribution

Treatment interruption rate among psychiatric patients varies from 26% to 82%. In order to evaluate the determinants of compliance and dropping out in out-patient psychiatric clinics, we utilized Ajzen's theory of planned behaviour.

In the pilot stage (n = 164), a questionnaire was administered to elicit the patient's salient beliefs associated with the intention to contact the service. In the main stage, a new, broader sample (n = 239) was asked to fill in a structured questionnaire including the basic components of the Ajzen's theory; a structural equation model was used for the evaluation of the fit between the relationships hypothesized by the theory and the empirical data gathered from the sample.

The most important predictor of 'intention' is 'perceived behavioural control', followed by 'attitude'. It was found that 'past behaviour' vs. 'intentions' was significant predictor of dropping out.

Dropout patients were more likely to have already been in psychiatric treatment and to have had a past history of missed appointments. Our results suggest that knowing previous treatment history and the role of interruptions could equip mental health carers for the rapid retrieval of dropouts, reducing the burden on patients' families and the risk of patients themselves.