Dropout Rates in Psychosocial Interventions for People With Both Severe Mental Illness and Substance Misuse: A Systematic Review and Meta-Analysis

Abstract

IntroductionOver the years, many psychosocial interventions for individual having both a psychotic spectrum disorder and a substance use disorder diagnoses have been developed and studied. However, there is a high dropout rate among this clinical population.ObjectivesThis meta-analysis aims to replicate a previous meta-analysis on the effects of psychosocial treatment for dual disorders, while including and determining the dropout rates in those type of interventions.MethodBased on a Cochrane systematic review conducted in 2019, we conducted a meta-analysis including 40 randomized clinical trials on psychosocial treatment among persons suffering from schizophrenia spectrum disorder and substance use disorder.ResultsA dropout rate of 27,2% was obtained. Stimulants use significantly affected dropout rates. Age, gender, diagnosis, alcohol and cannabis abuse, and duration of treatment did not affect dropout rates.ConclusionThe 27,2% rate of dropout from psychosocial treatment highlights the need to engage participants having a dual diagnosis from the start by focusing on therapeutic alliance and motivation for treatment.

Avatar Intervention for Cannabis Use Disorder in Individuals with Severe Mental Disorders: A Pilot Study

“…Due to the validation of the motivation to undertake such an intervention at the time of recruitment, a drastic reduction in drop out was observed. These changes lead to a rate similar to those obtained in other studies involving this complex population [ 90 ]. It can also be hypothesized that participants did not drop out because of the new treatment modality (VR), as nearly 50% of them decided to stop the intervention before the first immersive session.…”

“…In our study, apart from an amphetamine SUD, it was not possible to identify which profile of participants would be likely to complete the intervention or not. A meta-analysis likewise identified SUD to stimulants as an element that influences the drop rate in a population with SMD [ 90 ]. Nevertheless, our results could not be generalized due to the small sample.…”

The Impact of Therapeutic Community Gardening on the Wellbeing, Loneliness, and Life Satisfaction of Individuals with Mental Illness

“…At the first primary data collection timepoint (May-October 2021) 53 members completed a survey, reducing to 38 members at T3. This is equivalent to a dropout rate of 28.3% and is in line with dropout rates reported in psychosocial interventions (27.2%) for people with severe mental illness [ 62 ]. Despite the smaller sample sizes in females, the dropout rate for females was only 17.6% compared to 33% in males (17.6%).…”

Investigating the Effectiveness of Brexpiprazole in Subjects with Schizophrenia Spectrum Illness and Co-Occurring Substance Use Disorder: A Prospective, Multicentric, Real-World Study

“…However, we observed a high treatment dropout rate (29.2%), with 7 in 24 subjects discontinuing brexpiprazole treatment prior to one month, likely due to the inherent nature of the study. Indeed, these data can be elucidated by the intrinsic characteristics of the sample and the peculiar features of SUD, which may have influenced adherence to drug therapy (5 out of 7 patients discontinued treatment due to non-adherence to drug therapy), as evidenced by various studies on SUD [ 44 , 45 , 46 ]. On one hand, most patients were managed in an outpatient setting, which presented challenges for continuous monitoring and tracking in cases of missed appointments.…”