Dropout rates in psychological therapy for generalized anxiety disorder: Systematic review and meta-analysis

Poster C56, Wednesday, October%2010, 11:30%20am%20-%201:00%20pm, Essex%20Ballroom

Elon Gersh1; 1Orygen, the National Centre of Excellence in Youth Mental Health

Background: Generalized anxiety disorder (GAD) is among the least studied anxiety disorders, despite being among the most prevalent. Psychological therapy is a common treatment approach. Premature termination, or dropout, from therapy is problematic in that it can be associated with worse outcomes, service inefficiencies and can disproportionately affect disadvantaged populations. Yet, no research has systematically determined a weighted mean dropout for GAD and explored predictors of dropout. Methods: The literature was systematically reviewed using Medline, Embase and PsycINFO databases. Forty-five studies, involving 2224 participants were identified involving indivudal therapy for GAD. Results: Meta-analysis yielded a mean dropout rate of 16.99% (95% confidence interval 14.42%-19.91%). The Q-statistic indicated significant heterogeneity among studies. Moderator analysis and meta-regressions indicated no statistically significant effect of client age, sex, symptom severity, comorbidity, treatment type, study type (randomized trial or not), study quality, number of sessions or therapist experience on dropout rates. Discussion: Overall, dropout from psychological therapy can be expected in approximately one in six clients with GAD. There was no consistent predictive effect of any of the client, therapist of treatment variables studies in this review. More clear specification of the definition of dropout, reasons for dropout, and investigation of multiple correlates can assist in progressing future research.

Topic Area: Psychosocial Interventions

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