PMID- 28915423
OWN - NLM
STAT- MEDLINE
DCOM- 20180205
LR  - 20220408
IS  - 1532-8384 (Electronic)
IS  - 0010-440X (Linking)
VI  - 80
DP  - 2018 Jan
TI  - Premature psychotherapy termination in an outpatient treatment program for 
      personality disorders: a survival analysis.
PG  - 14-23
LID - S0010-440X(17)30194-3 [pii]
LID - 10.1016/j.comppsych.2017.08.001 [doi]
AB  - OBJECTIVE: Psychological treatment for patients with personality disorders (PD) 
      is plagued with a high proportion of early dropouts, and attempts to identify 
      risk factors for attrition have generated very few conclusive results. The 
      purpose of the present study is to identify significant predictors of early 
      treatment termination in a long-term psychotherapy program for PD. METHODS: Data 
      was retrospectively retrieved from 174 files of patients who began long-term 
      psychotherapy in an outpatient treatment program in Quebec City, Canada. 
      Socio-demographic, initial disturbance, and diagnostic variables were considered 
      for prediction, along with a measure specifically designed to identify PD 
      patients at risk of dropping out early from psychotherapy, the Treatment 
      Attrition-Retention Scale for Personality Disorders (TARS-PD). Survival analysis 
      using Cox proportional hazard regression was performed to identify significant 
      predictors. RESULTS: Results using univariate Cox proportional hazards 
      regressions revealed that unemployment, Global Assessment of Functioning scores, 
      and recent hetero-aggressive behavior were significant predictors of early 
      dropout in the first six months of therapy. Adjusting for these three 
      confounders, four of the factor scores from the TARS-PD (Narcissism, Secondary 
      gains, Low distress, and Cluster A features) were significantly associated with 
      dropout in univariate Cox proportional hazards regressions. Secondary gains and 
      Narcissism remained significant predictors after entering all five TARS-PD 
      factors in a multivariate Cox proportional hazards regression adjusting for 
      confounders. CONCLUSIONS: Taking into consideration specific treatment prognosis 
      variables, such as those measured by the TARS-PD, might be more useful for 
      dropout prediction in PD patients in comparison with more general demographic and 
      diagnostic variables.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Gamache, Dominick
AU  - Gamache D
AD  - Universite du Quebec a Trois-Rivieres, Departement de psychologie, C.P. 500, 
      Trois-Rivieres, QC, Canada; CERVO Research Center, 2601 Chemin de la Canardiere, 
      Quebec City, QC, Canada. Electronic address: dominick.gamache@uqtr.ca.
FAU - Savard, Claudia
AU  - Savard C
AD  - CERVO Research Center, 2601 Chemin de la Canardiere, Quebec City, QC, Canada; 
      Universite Laval, Faculte des Sciences de l'education, 2325 rue des 
      Bibliotheques, Quebec City, QC, Canada.
FAU - Lemelin, Sophie
AU  - Lemelin S
AD  - Clinique Focus, 3679, rue de l'Hetriere, Local 120, Saint-Augustin-de-Desmaures, 
      QC, Canada.
FAU - Cote, Alexandre
AU  - Cote A
AD  - Universite du Quebec a Trois-Rivieres, Departement de psychologie, C.P. 500, 
      Trois-Rivieres, QC, Canada.
FAU - Villeneuve, Evens
AU  - Villeneuve E
AD  - CERVO Research Center, 2601 Chemin de la Canardiere, Quebec City, QC, Canada; 
      Institut universitaire en sante mentale de Quebec, Centre de traitement le 
      Faubourg Saint-Jean, 2601 Chemin de la Canardiere, Quebec City, QC, Canada.
LA  - eng
PT  - Journal Article
DEP - 20170809
PL  - United States
TA  - Compr Psychiatry
JT  - Comprehensive psychiatry
JID - 0372612
SB  - IM
MH  - Adult
MH  - Aggression
MH  - Female
MH  - Humans
MH  - Male
MH  - Outpatients/psychology
MH  - Patient Dropouts/*psychology
MH  - Personality Disorders/*therapy
MH  - *Psychotherapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Unemployment/psychology
MH  - Young Adult
EDAT- 2017/09/16 06:00
MHDA- 2018/02/06 06:00
CRDT- 2017/09/16 06:00
PHST- 2017/05/03 00:00 [received]
PHST- 2017/07/06 00:00 [revised]
PHST- 2017/08/04 00:00 [accepted]
PHST- 2017/09/16 06:00 [pubmed]
PHST- 2018/02/06 06:00 [medline]
PHST- 2017/09/16 06:00 [entrez]
AID - S0010-440X(17)30194-3 [pii]
AID - 10.1016/j.comppsych.2017.08.001 [doi]
PST - ppublish
SO  - Compr Psychiatry. 2018 Jan;80:14-23. doi: 10.1016/j.comppsych.2017.08.001. Epub 
      2017 Aug 9.