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Tijdschrift voor Psychiatrie 52 (2010) 1, 17 - 27

New research

Drop-out from clinical psychotherapeutic treatment of personality problems

A.T.J. Cornelissen, E. Poppe, M.A. Ouwens

summary
background
Drop-out is a serious problem in psychotherapy. Earlier studies have shown that the main factors associated with drop-out are young age, low socio-economic status and pathological symptoms such as severity of the problems and problematic substance-abuse.
aim To investigate patient's and pathological characteristics that predict drop-out among patients with predominantly personality problems.
method Patient's characteristics and pathological characteristics of 372 subjects were ascertained via a retrospective study by means of four databases: intake letters, scid-ii personality questionnaires, scid-i and ii interviews and discharge letters. The association between these characteristics and drop-out was tested by means of bivariate and multivariate analysis.
results The drop-out rate was 33.3 %. The main predictors of drop-out were young age, a low Global Assessment of Functioning (gaf)-score and the existence of problematic substance-abuse at discharge. The degree and severity of axis i disorders and the nature of personality problems made hardly any contribution to the prediction of drop-out.
conclusion These findings indicate that more attention needs to be given to the existence of substance-abuse before psychotherapy begins. Drop-out is still a problem and is difficult to predict and hard to influence.

keywords clinical psychotherapy, drop-out, personality disorder