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Dropout prediction in a public mental health intervention for sub-threshold and mild panic disorder

Published online by Cambridge University Press:  11 March 2015

Peter Meulenbeek ,
Kristin Seeger  and
Peter M. ten Klooster
Peter Meulenbeek*
Affiliation:
Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands GGNet, Community Mental Health Centre, Enschede, The Netherlands
Kristin Seeger
Affiliation:
Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
Peter M. ten Klooster
Affiliation:
Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
*
*Author for correspondence: P. Meulenbeek, PhD, University of Twente and GGNet, Drienerlolaan 5, PO Box 217, 7500 AE Enschede, The Netherlands, The Netherlands (email: [email protected]).
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Abstract

Dropout is a common and serious problem in psychological research and practice. When participants terminate treatment prematurely, this may have methodological and clinical consequences. The aim of this study was to identify predictors of dropout in a sample of patients (N = 217) with sub-threshold and mild panic disorder treated with a public mental health intervention programme based on cognitive-behavioural principles. Three groups of possible baseline predictors were selected from the literature: (1) socio-demographic, (2) personal, and (3) illness-related variables. A total of 51 (23.5%) participants were classified as dropouts. Dropouts were further subdivided into pretreatment dropouts (n = 17) who attended no course sessions at all and regular dropouts (n = 34) who attended 1–5 course sessions. Multivariable logistic regression analyses were used to identify independent predictors of dropout. Few variables were significantly associated with increased odds of dropout and the total explained variance was small. Fewer years of education was the only independent predictor of total dropout and male gender was associated with more pretreatment dropout. No independent predictors were found for regular dropout. It can be concluded that it is difficult to precisely predict dropout risk in patients participating in a public mental health intervention for panic symptoms.

Keywords

Dropout predictionoutreachpanic disorderpublic mental health intervention
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e5
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Recommended follow-up reading

Davis, S, Hooke, GR, Page, AC (2006). Identifying and targeting predictors of drop-out from group cognitive behaviour therapy. Australian Journal of Psychology 58, 48–56.Google Scholar
Keijsers, JPG, Kampman, M, Hoogduin, CAL (2001). Dropout prediction in cognitive behavior therapy for panic disorder. Behavior Therapy 32, 739–749.Google Scholar
Meulenbeek, P, Willemse, G, Smit, F, Van Balkom, A, Spinhoven, P, Cuijpers, P (2010). Early intervention in panic: pragmatic randomised controlled trial. British Journal of Psychiatry 196, 326–331.Google Scholar
White, KS, Allen, AB, Barlow, DH, Gorman, JM, Shear, MK, Woods, SW (2010). Attrition in a multicenter clinical trial for panic disorder. Journal of Nervous and Mental Disease 198, 665–671.Google Scholar

References

Bados, A, Balaguer, G, Saldana, C (2007). Outcome of cognitive-behavioural therapy in training practice with anxiety disorder patients. British Journal of Clinical Psychology 46, 429–435.Google Scholar
Baekeland, F, Lundwall, L (1975). Dropping out of treatment: a critical review. Psychological Bulletin 82,738–783.Google Scholar
Batelaan, N, De Graaf, R, Van Balkom, A, Vollebergh, W, Beekman, A (2007). Thresholds for health and thresholds for illness: panic disorder versus subthreshold panic disorder. Psychological Medicine 37, 247–256.Google Scholar
Beck, AT, Steer, RA, Brown, GK (1996). Manual for the Beck Depression Inventory – II. San Antonio, TX: Psychological Corporation.Google Scholar
Chambless, DL, Caputo, GC, Jasin, SE, Gracely, EJ, Williams, C (1985). The Mobility Inventory for Agoraphobia. Behaviour Research and Therapy 23, 35–44.Google Scholar
Davis, S, Hooke, GR, Page, AC (2006). Identifying and targeting predictors of drop-out from group cognitive behaviour therapy. Australian Journal of Psychology 58, 48–56.Google Scholar
De Beurs, E (1993). The Assessment and Treatment of Panic Disorder and Agoraphobia. Amsterdam: Thesis Publications.Google Scholar
De Beurs, E, Smit, JH, Comijs, HC (2005). The Panic Opinion List (POL). The reliability and validity of a cognitive measure for panic disorder [in Dutch]. Gedragstherapie 38, 141–154.Google Scholar
Edlund, MJ, Wang, PS, Berglund, PA, Katz, SJ, Lin, E, Kessler, RC (2002). Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. American Journal of Psychiatry 159, 845–851.CrossRefGoogle ScholarPubMed
EuroQol Group (1990). EuroQol − a new facility for the measurement of health-related quality of life. Health Policy 16, 199–208.Google Scholar
Garfield, SL (1986). Research on client variables in psychotherapy. In: Handbook of Psychotherapy and Behavior Change, 3rd edn (ed. Garfield, S. L. and Bergin, A. E.), pp. 213–256). New York: Wiley.Google Scholar
Garfield, SL (1994). Research on client variables in psychotherapy. In: Handbook of Psychotherapy and Behavior Change, 4th edn (ed. Garfield, S. L. and Bergin, A. E.), pp. 190–228). New York: Wiley.Google Scholar
Grilo, MG, Money, R, Barlow, DH, Goddard, AW, Gorman, JM, Hofman, SG, Papp, LA, Shear, MK, Woods, SW (1998). Pretreatment patient factors predicting attrition from a multicenter randomized controlled treatment study for panic disorder. Comprehensive Psychiatry 39, 323–332.Google Scholar
Hakkaart-Van Roijen, L, Van Straten, A, Donker, M (2002). Manual Trimbos/iMTA questionnaire for costs associated with psychiatric illness (TIC-P) [in Dutch]. Rotterdam: Erasmus University.Google Scholar
Harvison, K, Woodruff-Borden, J, Jeffery, S (2004). Mismanagement of panic disorder in emergency departments: contributors, costs, and implications for integrated models of care. Journal of Clinical Psychology in Medical Settings 11, 217–232.Google Scholar
Keijsers, JPG, Kampman, M, Hoogduin, CAL (2001). Dropout prediction in cognitive behavior therapy for panic disorder. Behavior Therapy 32, 739–749.CrossRefGoogle Scholar
Mahon, J (2000). Dropping out from psychological treatment for eating disorders: what are the issues? European Eating Disorders Review 8, 198–216.Google Scholar
Meulenbeek, P, Willemse, G, Smit, F, Van Balkom, A, Spinhoven, P, Cuijpers, P (2010). Early intervention in panic: pragmatic randomised controlled trial. British Journal of Psychiatry 196, 326–331.CrossRefGoogle ScholarPubMed
Meyer, B, Pilkonis, PA, Krupnick, JL, Egan, MK, Simmens, JJ, Sotsky, SM (2002). Treatment expectancies, patient alliance and outcome: further analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology 70, 1051–1055.Google Scholar
Nantz, E, Liu-Seifert, H, Skljarevski, V (2009). Predictors of premature discontinuation of treatment in multiple disease states. Patient Preference and Adherence 3, 31–43.Google Scholar
Oostenbrink, JB, Koopmanschap, MA, Rutten, FF (2002). Standardisation of costs: the Dutch Manual for Costing in economic evaluations. Pharmacoeconomics 20, 443–454.Google Scholar
Otto, MW, Tuby, KS, Gould, RA, McLean, RYS, Pollack, MH (2001). An effect-size analysis of the relative efficacy and tolerability of serotonin selective reuptake inhibitors for panic disorder. American Journal of Psychiatry 158, 1982–1992.Google Scholar
Pearlin, LI, Schooler, C (1978). The structure of coping. Journal of Health and Social Behavior 19, 2–21.Google Scholar
Pekarik, G (1983). Improvement in clients who have given different reasons for dropping out of treatment. Journal of Clinical Psychology 39, 909–913.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
Pekarik, G (1985). Coping with dropouts. Professional Psychology: Research and Practice 16, 114–112.Google Scholar
Pekarik, G, Wierzbicki, M (1986). The relationship between clients’ expected and actual treatment duration. Psychotherapy 23, 532–534.Google Scholar
Reis, BF, Brown, LG (1999). Reducing psychotherapy dropouts: maximizing perspective convergence in the psychotherapy dyad. Psychotherapy 36, 123–136.Google Scholar
Saunders, JB, Aasland, OG, Barbor, TF, De la Fuente, JR, Grant, M (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction 88, 791–804.Google Scholar
Shear, MK, Rucci, P, Williams, J, Frank, E, Grochocinski, V, Vander Bilt, J, Houck, P, Wang, T (2001). Reliability and validity of the Panic Disorder Severity Scale: replication and extension. Journal of Psychiatric Research 35, 293–296.Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Herqueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 22–33.Google Scholar
Smit, F, Cuijpers, P, Oostenbrink, J, Batelaan, N, De Graaf, R, Beekman, A (2006). Costs of nine common mental disorders: implications for curative and preventive psychiatry. Journal of Mental Health Policy and Economics 9, 193–200.Google ScholarPubMed
Smits, CHM, Bosscher, RJ (1998). Predictors of self-efficacy and mastery. In: Autonomy and Well-being in the Aging Population II (ed. Deek, D. J. H., Beekman, A. T. F., Kriegsman, D. M. N. and Westendorp-de Serière, M.), pp. 105–114. Amsterdam: VU University Press.Google Scholar
Spinhoven, P, Ormel, J, Sloekers, PPA, Kempen, GIJM, Speckens, AEM, Van Hemert, AM (1997). A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychological Medicine 27, 363–370.CrossRefGoogle ScholarPubMed
Sue, S, McKinney, HL, Allen, DB (1976). Predictors of the duration of therapy for clients in the community mental health system. Community Mental Health Journal 12, 365–375.Google Scholar
Telch, MJ (1987). The Panic Appraisal Inventory. Unpublished manuscript, University of Texas.Google Scholar
Van der Does, AJW (2002). BDI-II-NL. Handleiding. De Nederlandse versie van de Beck Depression Inventory – 2nd edn [Dutch version of the Beck Depression Inventory – 2nd edn]. Lisse: Harcourt Test Publishers.Google Scholar
Van der Meer, A, Burgerhout, K (2004). Nederlandse versie van de Panic Disorder Severity Scale [Dutch version of the Panic Disorder Severity Scale]. Amsterdam: Universiteit van Amsterdam.Google Scholar
Van Vliet, IM, Leroy, H, Van Megen, HJGM (2000). MINI Plus: MINI Internationaal Neuropsychiatrisch Interview: Dutch version 5.0.0 [MINI Plus: MINI International Neuropsychiatric Interview: Dutch version 5.0.0]. Leiden: LUMC.Google Scholar
Veeninga, AT, Hafkenscheid, AJPM (2004). Expectations of patients starting psychotherapy: Predictors of drop-out? [in Dutch]. Tijdschrift voor Psychotherapie, 30, 187–195.Google Scholar
Visser, S (2001). Drop-outs in the treatment of hypochondria: characteristics and approach [in Dutch]. Directieve Therapie 21, 55–60.Google Scholar
Wade, WA, Treat, TA, Stuart, GL (1998). Transporting an empirically supported treatment for panic disorder to a service clinic setting: a benchmarking strategy. Journal of Consulting and Clinical Psychology 66, 231–239.Google Scholar
White, KS, Allen, AB, Barlow, DH, Gorman, JM, Shear, MK, Woods, SW (2010). Attrition in a multicenter clinical trial for panic disorder. Journal of Nervous and Mental Disease 198, 665–671.Google Scholar
Wierzbicki, M, Pekarik, G (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice 24, 190–195.Google Scholar
Wingerson, D, Sullivan, M, Dager, S, Flick, S (1993). Personality traits and early discontinuation from clinical trials in anxious patients. Journal of Clinical Psychopharmacology 13, 194–197.Google Scholar
Zigmond, AS, Snaith, RP (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361–370.Google Scholar
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