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Evaluating mental health services in a Greek community

The factor of non-compliance to therapy

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Abstract

This study aims to evaluate rendered mental health services for children and adolescents through the investigation of those factors which are related to non-compliance with therapy and which affect treatment outcome. Data were collected from the files of all new cases who applied to a Community Mental Health Centre in Athens during 2000–2002 (N = 363). For each case, the following factors were examined: age, sex, family situation, parents’ educational level, referral source, child’s psychiatric and psychosocial diagnoses, type of proposed therapy, phase at which termination of therapy occurred and outcome. Around 45.7% of the sample did not complete therapy. The probability of treatment compliance increased when the patient was male, with a diagnosis of a specific developmental disorder, treated in a well-structured therapy programme, was from a healthy family environment and his mother was better educated. On the contrary, an adverse family situation (one-parent family, inadequate parental supervision) and the female sex had a negative association with treatment compliance. Most of the cases discontinued their treatment upon completion of the diagnostic procedure. Referral source did not influence treatment compliance. Evaluation of our service has shown that more attention should be paid to less-educated families and those in adverse situations, particularly when the patient is female.

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References

  1. Abella A, Dufresne P, Gex Fabry M, et al. (2000) L’effet Pygmalion en pédopsychiatrie: relations entre les prédictions des cliniciens et les ruptures de traitement. Une étude prospective. Neuropsychiatrie de l’ Enfance et d’Adolescence 48:14–24

    Google Scholar 

  2. Bekker FJ, Hentschel U, Fujita M (1996) Basic cultural values and differences in attitudes toward health, illness and treatment preferences within a psychosomatic frame of reference. Psychotherapy and Psychosomatics 65:191–198

    PubMed  CAS  Google Scholar 

  3. Bickman L, Andrade AR, Lambert EW (2002) Dose response in child and adolescent mental health services. Journal of Mental Health Services Research 4:57–70

    Article  Google Scholar 

  4. Bickman L, Summerfel WT, Noser K (1997) Comparative outcomes of emotionally disturbed children and adolescents in a system of services and usual care. Psychiatric Services 48:1543–1548

    PubMed  CAS  Google Scholar 

  5. Blanz B, Schmidt MH (2000) Practitioner review: preconditions and outcome of inpatient treatment in child and adolescent psychiatry. Journal of Child Psychology and Psychiatry and Allied Disciplines 41:703–712

    CAS  Google Scholar 

  6. Bourgeois ML, Koleck M, Roig-Morrier R (2002) Mesure de la conscience du trouble chez 100 malades hospitalises en psychiatrie. Annales Medico-Psychologiques 160:444–450

    Article  Google Scholar 

  7. Brezinka (2002) Behavior therapy in children with conduct disorder. Zeitschrift für Kinder und Jugendpsychiatrie und Psychotherapie 30:41–50

    Article  PubMed  CAS  Google Scholar 

  8. Buchanan A (1992) A two-year prospective study of treatment compliance in patients with schizophrenia. Psychological Medicine 22:787–797

    Article  PubMed  CAS  Google Scholar 

  9. Capes J (1973) Evaluating services for adolescents, In: Wing JK, Hafner H (eds) Roots of evaluation: the epidemiological basis for planning psychiatric services, Oxford University Press, London

  10. Carpenter PJ, Range LM (1982) Predicting psychotherapy duration from therapists’ sex, professional affiliation, democratic values and community mental health ideology. Journal of Clinical Psychology 38:90–91

    PubMed  CAS  Google Scholar 

  11. Centorrino F, Hernan MA, Drago-Ferrante G (2001) Factors associated with noncompliance with psychiatric outpatient visits. Psychiatric Services 52:378–380

    Article  PubMed  CAS  Google Scholar 

  12. Colom F, Vieta E, Martinez Aran A (2000) Clinical factors associated with treatment noncompliance in euthymic bipolar patients. Journal of Clinical Psychiatry 61:549–555

    PubMed  CAS  Google Scholar 

  13. Cottrell D, Hill P, Walk D (1998) Factors influencing non-attendance at Child Psychiatry Out-Patient Appointments. British Journal of Psychiatry 152:201–204

    Article  Google Scholar 

  14. Cramer JA, Rosenheck R (1998) Compliance with medications regimens for mental and physical disorders. Psychiatric Services 49:196–201

    PubMed  CAS  Google Scholar 

  15. Eltz MJ, Shirk SR, Sarlin N (1995) Alliance formation and treatment outcome among maltreated adolescents. Child Abuse and Neglect 19:419–431

    Article  PubMed  CAS  Google Scholar 

  16. Fenton WS, Blyer CR, Heinssen R (1997) Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin 23:637–651

    PubMed  CAS  Google Scholar 

  17. Gavin LA, Wamboldt MZ, Sorokin N (1999) Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma. Journal of Pediatric Psychology 24:355–365

    Article  PubMed  CAS  Google Scholar 

  18. Gewirtz A, Gossart Walker S (2000) Home – based treatment for children and families affected by HIV and AIDS. Dealing with stigma, secrecy, disclosure and loss. Child and Adolescent Psychiatry Clinics of North America 9:313–330

    CAS  Google Scholar 

  19. Gould MS, Shaffer MD, Kaplan D (1985) The characteristics of dropouts from a Child Psychiatry Clinic. Journal of American Academy of Child and Adolescent Psychiatry 24:316–328

    Article  CAS  Google Scholar 

  20. Hack S, Chow B (2001) Pediatric psychotropic medication compliance: a literature review and research-based suggestions for improving treatment compliance. Journal of Child and Adolescent Psychopharmacology 11:59–67

    Article  PubMed  CAS  Google Scholar 

  21. Harrington RC, Kerfoot M, Verduyn C (1999) Developing needs led child and adolescent mental health services: issues and prospects. European Child and Adolescent Psychiatry 8:1–10

    Article  PubMed  CAS  Google Scholar 

  22. Holden W, Friedman R, Santiago R (2001) Overview of the national evaluation of the comprehensive community mental health services for children and their families. Journal of Emotional and Behavioral Disorders 9:4–12

    Article  Google Scholar 

  23. Horvath A, Luborsky L (1993) The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology 61:561–573

    Article  PubMed  CAS  Google Scholar 

  24. Huffine C (2002) Child and adolescent psychiatry: current trends in the community treatment of seriously emotional disturbed youths. Psychiatric Services 53:809–811

    Article  PubMed  Google Scholar 

  25. Hunter J, Higginson I, Garralda E (1996) Systematic literature review: outcome measures for child and adolescent mental health services. Journal of Public Health and Medicine 18:197–206

    CAS  Google Scholar 

  26. Kazdin A, Jennifer L, Mazurick M, Siegel T (1994) Treatment outcome among children with external disorder who terminate prematurely versus those who complete psychotherapy. Journal of American Academy of Child and Adolescent Psychiatry 33:4–9

    Article  Google Scholar 

  27. Kazdin AΕ, Mazurick JL, Bass D (1993) Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology 22:2–16

    Article  Google Scholar 

  28. Kourani RFC, Garber J, Tornusciolo G (1990) Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of American Academy of Child and Adolescent Psychiatry 29:657–660

    Article  Google Scholar 

  29. Lazaratou H, Vlassopoulos M, Dellatolas G (2000) Factors affecting compliance with treatment in an outpatient Child Psychiatric Practice: a retrospective study in a Community Mental Health Center in Athens. Psychotherapy and Psychosomatics 69:42–49

    Article  PubMed  CAS  Google Scholar 

  30. Lerner Y, Zilber N, Barasch M, Wittman L (1993) Utilization patterns of community mental health services by newly referred patients. Social Psychiatry and Psychiatric Epidemiology 28:7–22

    Article  Google Scholar 

  31. Liakopoulou M, Protagora D, Hatzielefteriou M (1993) Consultation – Liaison Child Psychiatry: patient’s characteristics and reasons related to drop-out from follow-up. Psychiatry 5:38–41, (in Greek)

    Google Scholar 

  32. Lucas G, Mylona E (2002) ‘Etude différentielle des modes de cessation en consultations thérapeutiques et traitements á séances régulières. Psychiatrie de l’enfant: quels patients, quels traitements. Collt P.U.F., Paris

    Google Scholar 

  33. Madianos M, Economou M, Papageorgiou A, Stefanis C (1995) The first Community Mental Health Center in Greece: fifteen years of integrated mental health care and psychosocial rehabilitation. International Journal of Psychosocial Rehabilitation 1:110–114

    Google Scholar 

  34. Madianos M, Zarnari O (1998) Health and Greek Society. NSSC, Athens

    Google Scholar 

  35. Marriage K, Petrie J, Worling D (2001) Consumer satisfaction with an adolescent inpatient psychiatric unit. Canadian Journal of Psychiatry 46:969–975

    CAS  Google Scholar 

  36. Mc Donald J, Brown N, Ellis P (2000) Using telephone prompts to improve initial attendance at a community mental health center. Psychiatric Services 51:812–814

    Article  Google Scholar 

  37. Rey JM, Plapp JM, Simpson PL (1999) Parental satisfaction and outcome: a 4-year study in a child and adolescent mental health service. Australian and New Zealand Journal of Psychiatry 33:22–28

    Article  PubMed  CAS  Google Scholar 

  38. Riepe FG, Krone N, Viemann M (2002) Management of congenital adrenal hyperplasia. Results of the ESPE questionnaire. Hormones-Research 58:196–205

    Article  CAS  Google Scholar 

  39. Semansky RM, Koyanagi C (2003) Accessing Medicaid’s Child Mental Health Services: the experience of parents in two States. Psychiatric Services 54:475–476

    Article  PubMed  Google Scholar 

  40. Slade M (2002) What outcomes to measure in routine mental health services and how to assess them: a systematic review. Australian and New Zealand Journal of Psychiatry 36:743–53

    Article  PubMed  Google Scholar 

  41. Turgay A (1990) Treatment outcome for children and adolescents with conversion disorder. Canadian Journal of Psychiatry 35:585–589

    CAS  Google Scholar 

  42. Walk-on GO (1986) Patient compliance in the mental health continuum of care. Journal of Compliance in Health Care 1:75–89

    Google Scholar 

Download references

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Correspondence to Dimitris C. Anagnostopoulos.

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Anagnostopoulos, D.C., Vlassopoulos, M., Lazaratou, H. et al. Evaluating mental health services in a Greek community. Eur Child Adolesc Psychiatry 15, 435–441 (2006). https://doi.org/10.1007/s00787-006-0554-3

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