Fatores associados ao abandono de tratamento em saúde mental em uma unidade de nível secundário do sistema municipal de saúde

Abstract

Psychiatric out-treatment drop-out is a relevant clinical and economical issue. Drop-out rates in psychiatry are higher than in any other medical specialties. Articles published in the last 15 years have identified several factors statistically associated to no-compliance and treatment dropping-out. Objetive: The objective of this paper is to evaluate demographical, psychopathological, diagnose and treatment variables as possible predictors of attrition from a mental health out-service. Method: Natural experiment, evaluating 896 patients referred by primary care units from April 2004 till March 2006. Results: Single patients, unemployed people, and those whose age was below group-average (39.2 years) dropped-out significantly more than others. Two variables related to psychopathological examination were associated to treatment drop-out (recent memory and relation of affective disposition to current circumstances). Adult patients that received a diagnosis of Mental Retardation and those with a diagnosis related to groups F80-F98 (CID-10) also dropped-out significantly more. The identification of a psychiatric comorbidity and exclusively pharmacological treatment were associated to adherence. Conclusion: Results support the findings of different researchers as to the evidence of characteristics associated to treatment dropping-out. These findings suggest that certain group of patients need a more customized care, in order to positively influence their final adherence to their treatment.