Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan

Figures & data

Figure 1 Patient selection.

Abbreviations: MRI, magnetic resonance imaging; KPUM, Kyoto Prefectural University of Medicine.

Table 1 Demographic characteristics of the patients and treating psychiatrists

Factor	Number of patients
Patients
Sex
Male	224
Female	308
Age
18–25 years	106
26–45 years	227
46–65 years	141
≥66 years	58
Diagnosis
Mood disordersa	176
Anxiety disordersb	356
Education
Low	349
High	183
Occupation
None	86
Housewife/student	184
Employed	262
Marital status
Married	224
Divorced/widowed	83
Single	225
GAF score
≤50	148
51–60	248
≥61	136
CGI-S score
1–2	51
3–4	375
5–6	106
Previous treatment
No	202
Yes	330
Psychiatrists
Sex
Male	429
Female	103
Marital status
Married	389
Divorced/widowed	51
Single	92
Experience in years
<10 years	328
≥10 years	204
Sex concordance
Concordant	246
Discordant	286

Notes:

a Identified using International Classification of Diseases, 10th revision (ICD-10), code F3;

b identified using ICD-10 code F4.

Abbreviations: CGI-S, Clinical Global Impression–Severity of Illness; GAF, Global Assessment of Functioning.

Table 2 Difference in demographic characteristics between continuing and dropout patients

Factor	Continuing (n=342)	Dropout (n=190) (%)a
Patients
Sex
Male	144	80 (15.0)
Female	198	110 (20.7)
Age
18–25 years	56	50 (9.4)
26–45 years	148	79 (14.8)
46–65 years	100	41 (7.7)
≥66 years	38	20 (3.8)
Diagnosis
Mood disorders	117	59 (11.1)
Anxiety disorders	225	131 (24.6)
Education
Low	207	142 (26.7)
High	135	48 (9.0)
Occupation
None	59	27 (5.1)
Housewife/student	114	70 (13.2)
Employed	169	93 (17.5)
Marital status
Currently married	154	70 (13.2)
Divorced/widowed	45	38 (7.1)
Single	143	82 (15.4)
GAF score
≤50	97	51 (9.6)
51–60	168	80 (15.0)
≥61	77	59 (11.1)
CGI-S score
1–2	29	22 (4.1)
3–4	242	133 (25.0)
5–6	71	35 (6.6)
Previous treatment
No	128	74 (13.9)
Yes	214	116 (21.8)
Psychiatrists
Sex
Male	284	145 (27.3)
Female	58	45 (8.5)
Marital status
Married	261	128 (24.1)
Divorced/widowed	26	25 (4.7)
Single	55	37 (7.0)
Experience in years
<10 years	199	129 (24.2)
≥10 years	143	61 (11.5)
Sex concordance
Concordant	165	81 (15.2)
Discordant	177	109 (20.5)

Note:

a The denominator for this percentage is the total number of patients in the study sample (n=532).

Abbreviations: CGI-S, Clinical Global Impression–Severity of Illness; GAF, Global Assessment of Functioning.

Figure 2 Proportion of continuing patients according to the treating psychiatrists’ experience in years.

Table 3 Results of univariate and multivariate Cox regression analyses of factors associated with patient dropout

Factor	Univariate			Multivariate
	HR	95% Cl	P-value	HR	95% Cl	P-value
Patients
Sex
Male	1.01	(0.76–1.35)	0.93	1.14	(0.80–1.61)	0.51
Female	Reference
Age
18–25 years	1.38	(0.82–2.32)	0.22	1.82	(1.01–3.46)	<0.05
26–45 years	0.92	(0.56–1.50)	0.73	1.28	(0.77–2.26)	0.32
46–65 years	0.76	(0.44–1.30)	0.31	0.90	(0.54–1.58)	0.77
≥66 years	Reference
Diagnosis
Mood disorders	0.86	(0.64–1.18)	0.35	0.83	(0.60–1.14)	0.24
Anxiety disorders	Reference
Education
Low	1.72	(1.24–2.39)	<0.01	1.64	(1.17–2.31)	<0.01
High	Reference
Occupation
None	0.83	(0.54–1.28)	0.40	0.66	(0.42–1.05)	0.08
Housewife/student	1.09	(0.80–1.48)	0.61	0.67	(0.60–1.25)	0.44
Employed	Reference
Marital status
Married	0.86	(0.62–1.18)	0.34	1.12	(0.75–1.67)	0.60
Divorced/widowed	1.37	(0.93–2.01)	0.11	1.58	(1.03–2.43)	<0.05
Single	Reference
GAF
≤50	0.72	(0.50–1.05)	0.09	0.76	(0.43–1.34)	0.34
51–60	0.66	(0.47–0.93)	<0.05	0.63	(0.42–0.94)	<0.05
61–100	Reference
CGI-S
1–2	1.55	(0.91–2.65)	0.11	2.01	(0.57–2.70)	0.60
3–4	1.10	(0.76–1.60)	0.60	1.07	(0.69–2.13)	0.50
5–6	Reference
Previous treatment
Yes	1.03	(0.77–1.38)	0.85	0.96	(0.71–1.29)	0.77
No	Reference
Psychiatrists
Sex
Male	0.72	(0.52–1.01)	0.06	0.80	(0.57–1.12)	0.50
Female	Reference
Marital status
Married	0.79	(0.55–1.14)	0.21	0.90	(0.60–1.36)	0.62
Divorced/widowed	1.23	(0.74–2.04)	0.43	1.15	(0.67–1.95)	0.62
Single	Reference
Experience in years
<10 years	1.44	(1.06–1.96)	<0.05	1.31	(0.94–1.85)	0.11
≥10 years	Reference
Sex concordance
Concordant	0.83	(0.63–1.11)	0.21	0.73	(0.52–1.02)	0.07
Discordant	Reference

Abbreviations: CGI-S, Clinical Global Impression–Severity of Illness; GAF, Global Assessment of Functioning; CI, confidence interval; HR, hazard ratio.

Table 4 Results of multivariate Cox regression analyses of factors associated with patient dropout according to diagnosis

Factor	Mood disorders			Anxiety disorders
	HR	95% Cl	P-value	HR	95% Cl	P-value
Patients
Sex
Male	1.42	(0.73–2.79)	0.31	1.16	(0.76–1.76)	0.50
Female	Reference
Age
18–25 years	1.64	(0.52–5.15)	0.39	2.33	(1.09–4.97)	<0.05
26–45 years	0.69	(0.26–1.85)	0.46	1.45	(0.74–2.84)	0.27
46–65 years	0.85	(0.34–2.11)	0.72	0.96	(0.48–1.91)	0.90
≥66 years	Reference
Education
Low	2.48	(1.24–2.39)	<0.05	1.41	(0.94–2.11)	0.10
High	Reference
Occupation
None	0.56	(0.24–1.31)	0.18	0.74	(0.42–1.29)	0.28
Housewife/student	0.48	(0.20–1.14)	0.10	1.05	(0.69–1.60)	0.83
Employed	Reference
Marital status
Married	1.25	(0.59–2.68)	0.56	1.07	(0.66–1.73)	0.79
Divorced/widowed	2.23	(1.01–4.89)	<0.05	1.57	(0.90–2.74)	0.12
Single	Reference
GAF
≤50	1.32	(0.49–3.56)	0.59	0.59	(0.43–1.34)	0.17
51–60	1.37	(0.62–3.03)	0.44	0.46	(0.42–0.94)	<0.05
61–100	Reference
CGI-S
1–2	0.41	(0.39–4.34)	0.46	1.26	(0.49–3.23)	0.63
3–4	1.68	(0.61–4.60)	0.32	1.09	(0.52–2.29)	0.82
5–6	Reference
Previous treatment
Yes	0.78	(0.43–1.43)	0.42	0.90	(0.61–1.31)	0.57
No	Reference
Psychiatrist
Sex
Male	0.84	(0.39–1.83)	0.67	0.77	(0.47–1.25)	0.29
Female	Reference
Marital status
Married	1.46	(0.56–3.82)	0.44	0.82	(0.51–1.31)	0.40
Divorced/widowed	1.34	(0.49–3.67)	0.57	1.29	(0.66–2.54)	0.46
Single	Reference
Experience in years
<10 years	1.32	(0.69–2.54)	0.40	1.31	(0.87–1.98)	0.20
≥10 years	Reference
Sex concordance
Concordant	0.65	(0.35–1.22)	0.18	0.64	(0.42–0.97)	<0.05
Discordant	Reference

Abbreviations: CGI-S, Clinical Global Impression–Severity of Illness; GAF, Global Assessment of Functioning; CI, confidence interval; HR, hazard ratio.