FACTORS RELATED TO DROPOUT FROM TREATMENT IN TWO OUTPATIENT TREATMENTS FOR BORDERLINE PERSONALITY DISORDER

• Published in: Journal of personality disorders Vol. 27; no. 6; pp. 716 - 726
• Main Authors: WNUK, Susan, McMAIN, Shelley, LINKS, Paul S, HABINSKI, Liat, MURRAY, Joshua, GUIMOND, Tim
• Format: Journal Article
• Language: English
• Published: New York, NY Guilford 01.12.2013; Guilford Press
• Subjects: Adult; Adult and adolescent clinical studies; Ambulatory Care; Anger; Behavior Therapy - methods; Biological and medical sciences; Borderline Personality Disorder - psychology; Borderline Personality Disorder - therapy; Comorbidity; Conceptual Tempo; Dropout Rate; Female; Health behavior; Humans; Impulsive Behavior; Male; Medical sciences; Middle Aged; Outpatient care facilities; Outpatients; Patient Dropouts - psychology; Patient Dropouts - statistics & numerical data; Personality disorders; Personality Problems; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Treatment dropout; Human; Borderline; Treatment; Personality disorder
• ISSN: 0885-579X; 1943-2763
• DOI: 10.1521/pedi_2013_27_106

Patients with borderline personality disorder frequently drop out prematurely from psychotherapy. This study examined factors related to treatment attrition in 180 patients enrolled in a randomized controlled trial comparing 1 year of Dialectical Behavior Therapy (DBT) to General Psychiatric Management (GPM). Completers and dropouts were compared on a range of variables, including demographics, Axis I and Axis II disorders, anger and impulsivity, therapeutic alliance, and treatment condition. The participants were on average 30.36 years old and 86% were female. Regression analyses revealed that individuals who dropped out had higher levels of anger (p = .01), greater Axis I comorbidity (p = .03), poorer therapeutic alliance (p = .003), and a higher number of lifetime suicide attempts (p = .05). An interaction was also found between Axis I comorbidity and treatment condition, with significantly lower rates of dropout seen in individuals with high Axis I comorbidity who were assigned to GPM compared to those assigned to DBT (p < .001).