CORRELATES OF PATIENT ATTRITION IN THE OUTPATIENT TREATMENT OF ALCOHOLISM

Abstract

Study of the admission characteristics of 143 patients admitted to an alcoholic clinic showed them to be a heterogeneous population with apparently different reasons for failing to persevere in treatment. Immediate dropouts (those who failed to return after the first visit), who comprised 17.5 per cent of the patients, were most likely to live alone and had suffered the least impairment of their capacity. They were also characterized by ambivalence about initiating treatment and were anxious, depressed, and not abstinent on admission. Rapid dropouts (those who dropped out after 1 to 4 weeks of treatment) accounted for 25.9 per cent of patients and were marked by high levels of anxiety, depression, and somatic and psychosomatic symptoms. Slow dropouts (those who dropped out during the 2nd to 5th months of treatment) had lower levels of education and were likely to have alcoholic relatives. On the other hand, clinic attenders (those who attended ≥ 6 months) accounted for only 26.6 per cent of patients. They tended to be relatively highly motivated, mildly symptomatic and socially intact individuals without a family history of alcoholism who were not markedly ambivalent about treatment.