The role of the family in the psychiatric treatment dropout

Abstract

Objectives. The aims of our study were to classify the reasons for psychiatric treatment dropout. Materials and methods. 300 patients diagnosed with schizophrenia and bipolar I disorders who had discontinued psychiatric treatment were questioned about the reasons for discontinuation during 2014. Reasons included the report of the patient and conclusions drawn by the psychiatrists based on the whole context of the patient's life and family reports. The study sample included only patients with at least two hospital admissions, in order to make sure they had some experience with psychiatric disorders, psychiatric treatment and were under specialized treatment, thus a confirmed diagnosis.Results. The first reason of dropout is reported as follows: 36.6% of dropout results due to lack of insight; 31.7% due to side effects; 8.4% for economic reasons; 23.3% after significant improvement of the symptoms. 79% of subjects revealed that the second reason is related to family care and support. This derives from two main causes: 42% because of continuous poor family support, related to the socioeconomic status, and 37% due to decrease in family support, mainly as a result of parents' loss or aging, or emigration of siblings. Conclusions. Dropout of psychiatric treatment brings a lot of challenges for the mental health system. Many of the factors are changeable. Dropout factors vary from disorder-related to socialrelated issues. Primary reasons are related to the disorders and medication; family-related causes seem to be very important factors that influence dropout from psychiatric treatment. Professional workers and family care should be better oriented for an overall better mental health care.