The Dropout Rates and Associated Factors in Patients with Mood Disorders in Long-term Naturalistic Treatment
Wooyoung Jung1, Eunsoo Moon2,3, Hyun Ju Lim2, Je Min Park2,3, Byung Dae Lee2,3, Young Min Lee2,3, Heejeong Jeong2, Hwagyu Suh2, Kyungwon Kim2
1Jung Wooyoung Psychiatry Clinic, Busan, Korea
2Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
3Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Korea
Correspondence to: Eunsoo Moon
Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
E-mail: esmun@hanmail.net
ORCID: https://orcid.org/0000-0002-8863-3413
Received: April 10, 2023; Revised: May 9, 2023; Accepted: May 22, 2023; Published online: July 27, 2023.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: Although maintenance treatment for mood disorders is important, the treatment discontinuation rate is reported to be high. This study aimed to investigate the dropout rates and associated factors in mood disorders.
Methods: The patients in a mood disorder clinic (n = 535) were examined. Demographic and clinical factors, scores of psychometric scales, time to dropout from initial treatment in patients with bipolar disorder (BP) (n = 288) and depressive disorder (DD) (n = 143) were evaluated based on database of the mood disorder clinic.
Results: Among the studied patients with BP and DD, 50% showed dropout in 4.05 and 2.17 years, respectively. The mean survival times were 8.90 years in bipolar disorder I (BP-I), 5.19 years in bipolar II disorder, 3.22 years in bipolar disorder not otherwise specified, 4.24 years in major depressive disorder, and 4.03 years in other depressive disorders. In the multivariate Cox proportional hazards regression model in the BP group, diagnosis BP-I was found to be significantly related to the decrease in dropout rate (hazard ratio [HR] = 0.22, p = 0.001); however, increased past suicide attempt number was significantly related to the increase in dropout rate (HR = 1.13, p = 0.017). In the DD group, none of anxiety disorders as comorbidity, increased scores of openness, and extraversion personality were related to the increase in dropout rate.
Conclusion: Patients with BP, especially BP-I, showed a lower dropout rate as compared to patients with other mood disorders.
Keywords: Bipolar disorder; Depressive disorder; Affect; Treatment adherence


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