The Dropout Rates and Associated Factors in Patients with Mood Disorders in Long-term Naturalistic Treatment

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Research

Background:

• Maintenance treatment is crucial for mood disorders, yet high discontinuation rates pose a significant clinical challenge.
• Understanding factors influencing treatment dropout is essential for improving patient outcomes in mood disorder management.

Purpose of the Study:

• To investigate treatment discontinuation rates in patients with bipolar disorder (BP) and depressive disorder (DD).
• To identify demographic and clinical factors associated with treatment dropout in these mood disorders.

Main Methods:

• Retrospective analysis of 535 patients from a mood disorder clinic database.
• Evaluation of demographic data, clinical factors, psychometric scores, and time to dropout for BP (n=288) and DD (n=143) patients.

Main Results:

• 50% of BP and DD patients discontinued treatment at 4.05 and 2.17 years, respectively.
• Bipolar I disorder (BP-I) diagnosis was associated with a decreased dropout rate (HR=0.22, p=0.001), while increased past suicide attempts correlated with higher dropout (HR=1.13, p=0.017) in BP patients.
• No significant association was found between anxiety comorbidity, openness, or extraversion and dropout rates in the DD group.

Conclusions:

• Patients with bipolar disorder, particularly BP-I, demonstrated lower treatment discontinuation rates compared to other mood disorder patients.
• Suicide attempt history is a significant predictor of dropout in bipolar disorder, highlighting the need for targeted interventions.