Treatment Attrition and Relapse Readmission in Psychiatric Inpatients: Predictors of Treatment Engagement and Psychiatric Relapse

Abstract

A large-scale study was conducted to investigate the causes of relapse readmission and treatment attrition in psychiatric inpatients. Two hundred thirty-three veterans receiving care within the VA medical system completed questionnaires related to their expectations of treatment and their planned level of investment in treatment efforts. Follow-up information was collected over two years following discharge from intensive psychiatric treatment via computerized medical records. This information was used in survival analyses to identify risk factors for psychiatric relapse and treatment dropout. Over the course of the follow-up period, 86.7% lost contact with treatment professionals and 63.5% of veterans were readmitted for an additional psychiatric inpatient treatment. A combination of demographic, illness, social, cognitive, and behavioral factors were found to be predictive of both relapse and attrition, although treatment attrition was not found to be related to psychiatric readmission. Implications of these findings are discussed and recommendations are made to help clinicians identify and respond to veterans most likely to leave treatment or need additional intensive psychiatric care