Predictors of Dropout From a Psychodynamic Hospitalization-Based Treatment for Personality Disorders

Today, psychotherapy is the treatment of choice for patients with a personality disorder (PD). PD patients are however difficult to engage into treatment and little is known about the factors that lead to dropout. The aim of this study was to increase our understanding of dropout in PD patients. In particular, and based on earlier studies, we aimed to identify baseline patient factors predicting dropout from a psychodynamic hospitalization-based treatment program. Results in a sample of 129 well-screened PD patients showed (a) a dropout rate of 34%, which is in line with earlier studies; (b) univariate analysis indicated that a lower educational level, the presence of Cluster A PD, especially schizoid PD, the total number of Axis II disorders, and the total number of Axis I disorders were predictive of dropout; and (c) when these variables were entered in a stepwise logistic regression analysis, the only significant predictor of dropout was the number of Axis II diagnoses. Dropout from a hospitalization-based psychodynamic treatment program was thus associated with a higher number of Axis II diagnoses (odds ratio = 1.73, 95% confidence interval [1.16, 2.57]). These findings suggest that the more serious one's personality pathology is at the start of treatment, the higher the chance patients will drop out from our treatment program. Implications for the psychosocial treatment of PD patients are formulated.