Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors.

Helle Møller Søndergaard; Per Hove Thomsen; Pernille Pedersen; Erik Pedersen; Agnethe Elkjaer Poulsen; Jette Mosekjær Nielsen; Lars Winther; Anne Henriksen; Berit Rungø; Hans Jørgen Søgaard

doi:10.4088/JCP.14m09270

Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors.

Helle Møller Søndergaard, Per Hove Thomsen, Pernille Pedersen, Erik Pedersen, Agnethe Elkjaer Poulsen, Jette Mosekjær Nielsen, Lars Winther, Anne Henriksen, Berit Rungø, Hans Jørgen Søgaard

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Objective: Knowledge of factors associated with treatment dropout and missed appointments in adults with attention-deficit/ hyperactivity disorder (ADHD) is very limited. On the basis of proposed hypotheses that past behavior patterns are more predictive of current behaviors of treatment dropout and missed appointments than are sociodemographic and clinical characteristics, we examined the associations of sociodemographic variables, clinical variables, risk-taking behavior, educational and occupational instability, and behaviors during mandatory schooling with the primary outcome measures of treatment dropout and missed appointments. Method: In a naturalistic cohort study of 151 adult outpatients with ADHD initiating assessment in a Danish ADHD unit from September 1, 2010, to September 1, 2011, the Adult ADHD Self-Report Scale v1.1 symptom checklist (ASRS) and a thorough clinical interview were used to assess ADHD according to DSM-IV-TR criteria. Stepwise logistic regression analysis was used to estimate reported associations. Results: A total of 27% of patients dropped out of treatment and a total of 42% had ≥ 3 missed appointments during treatment. Mood and anxiety disorders significantly lowered the odds of treatment dropout (odds ratio [OR] = 0.18; 95% confidence interval [CI], 0.050.65), whereas having started but not completed 2 or more educational programs apart from mandatory schooling significantly increased the odds of dropout (OR = 3.01; 95% CI, 1.326.89). Variables significantly associated with most missed appointments were low educational level (OR = 2.19; 95% CI, 1.124.31), 3 or more employments of less than 3 months' duration (OR = 2.86; 95% CI, 1.306.28), and having skipped class often/very often during mandatory schooling (OR = 2.65; 95% CI, 1.295.43). Additionally, the predominantly inattentive ADHD (ADHD-I) subtype lowered the odds of missed appointments (OR = 0.17; 95% CI, 0.050.62). Conclusion: Our results suggest that past behavior in terms of highest dropout rates in the educational and occupational systems and highest rates of skipping class during mandatory schooling is equally associated with current behavior of treatment dropout and missed appointments as are sociodemographic and clinical factors.

Original language	English
Journal	Journal of Clinical Psychiatry
Volume	77
Issue	2
Pages (from-to)	232-239
Number of pages	8
ISSN	0160-6689
DOIs	https://doi.org/10.4088/JCP.14m09270
Publication status	Published - 24 Feb 2016

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10.4088/JCP.14m09270

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Søndergaard, H. M., Thomsen, P. H., Pedersen, P., Pedersen, E., Poulsen, A. E., Nielsen, J. M., Winther, L., Henriksen, A., Rungø, B., & Søgaard, H. J. (2016). Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors. Journal of Clinical Psychiatry, 77(2), 232-239. https://doi.org/10.4088/JCP.14m09270

@article{988a60e2448c425480e374f554e0e979,

title = "Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors.",

abstract = "Objective: Knowledge of factors associated with treatment dropout and missed appointments in adults with attention-deficit/ hyperactivity disorder (ADHD) is very limited. On the basis of proposed hypotheses that past behavior patterns are more predictive of current behaviors of treatment dropout and missed appointments than are sociodemographic and clinical characteristics, we examined the associations of sociodemographic variables, clinical variables, risk-taking behavior, educational and occupational instability, and behaviors during mandatory schooling with the primary outcome measures of treatment dropout and missed appointments. Method: In a naturalistic cohort study of 151 adult outpatients with ADHD initiating assessment in a Danish ADHD unit from September 1, 2010, to September 1, 2011, the Adult ADHD Self-Report Scale v1.1 symptom checklist (ASRS) and a thorough clinical interview were used to assess ADHD according to DSM-IV-TR criteria. Stepwise logistic regression analysis was used to estimate reported associations. Results: A total of 27% of patients dropped out of treatment and a total of 42% had ≥ 3 missed appointments during treatment. Mood and anxiety disorders significantly lowered the odds of treatment dropout (odds ratio [OR] = 0.18; 95% confidence interval [CI], 0.050.65), whereas having started but not completed 2 or more educational programs apart from mandatory schooling significantly increased the odds of dropout (OR = 3.01; 95% CI, 1.326.89). Variables significantly associated with most missed appointments were low educational level (OR = 2.19; 95% CI, 1.124.31), 3 or more employments of less than 3 months' duration (OR = 2.86; 95% CI, 1.306.28), and having skipped class often/very often during mandatory schooling (OR = 2.65; 95% CI, 1.295.43). Additionally, the predominantly inattentive ADHD (ADHD-I) subtype lowered the odds of missed appointments (OR = 0.17; 95% CI, 0.050.62). Conclusion: Our results suggest that past behavior in terms of highest dropout rates in the educational and occupational systems and highest rates of skipping class during mandatory schooling is equally associated with current behavior of treatment dropout and missed appointments as are sociodemographic and clinical factors.",

author = "S{\o}ndergaard, {Helle M{\o}ller} and Thomsen, {Per Hove} and Pernille Pedersen and Erik Pedersen and Poulsen, {Agnethe Elkjaer} and Nielsen, {Jette Mosekj{\ae}r} and Lars Winther and Anne Henriksen and Berit Rung{\o} and S{\o}gaard, {Hans J{\o}rgen}",

year = "2016",

month = feb,

day = "24",

doi = "10.4088/JCP.14m09270",

language = "English",

volume = "77",

pages = "232--239",

journal = "Journal of Clinical Psychiatry",

issn = "0160-6689",

publisher = "Physicians Postgraduate Press, Inc",

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Søndergaard, HM, Thomsen, PH , Pedersen, P, Pedersen, E, Poulsen, AE, Nielsen, JM, Winther, L, Henriksen, A, Rungø, B & Søgaard, HJ 2016, 'Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors.', Journal of Clinical Psychiatry, vol. 77, no. 2, pp. 232-239. https://doi.org/10.4088/JCP.14m09270

Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors. / Søndergaard, Helle Møller; Thomsen, Per Hove ; Pedersen, Pernille et al.
In: Journal of Clinical Psychiatry, Vol. 77, No. 2, 24.02.2016, p. 232-239.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors.

AU - Søndergaard, Helle Møller

AU - Thomsen, Per Hove

AU - Pedersen, Pernille

AU - Pedersen, Erik

AU - Poulsen, Agnethe Elkjaer

AU - Nielsen, Jette Mosekjær

AU - Winther, Lars

AU - Henriksen, Anne

AU - Rungø, Berit

AU - Søgaard, Hans Jørgen

PY - 2016/2/24

Y1 - 2016/2/24

N2 - Objective: Knowledge of factors associated with treatment dropout and missed appointments in adults with attention-deficit/ hyperactivity disorder (ADHD) is very limited. On the basis of proposed hypotheses that past behavior patterns are more predictive of current behaviors of treatment dropout and missed appointments than are sociodemographic and clinical characteristics, we examined the associations of sociodemographic variables, clinical variables, risk-taking behavior, educational and occupational instability, and behaviors during mandatory schooling with the primary outcome measures of treatment dropout and missed appointments. Method: In a naturalistic cohort study of 151 adult outpatients with ADHD initiating assessment in a Danish ADHD unit from September 1, 2010, to September 1, 2011, the Adult ADHD Self-Report Scale v1.1 symptom checklist (ASRS) and a thorough clinical interview were used to assess ADHD according to DSM-IV-TR criteria. Stepwise logistic regression analysis was used to estimate reported associations. Results: A total of 27% of patients dropped out of treatment and a total of 42% had ≥ 3 missed appointments during treatment. Mood and anxiety disorders significantly lowered the odds of treatment dropout (odds ratio [OR] = 0.18; 95% confidence interval [CI], 0.050.65), whereas having started but not completed 2 or more educational programs apart from mandatory schooling significantly increased the odds of dropout (OR = 3.01; 95% CI, 1.326.89). Variables significantly associated with most missed appointments were low educational level (OR = 2.19; 95% CI, 1.124.31), 3 or more employments of less than 3 months' duration (OR = 2.86; 95% CI, 1.306.28), and having skipped class often/very often during mandatory schooling (OR = 2.65; 95% CI, 1.295.43). Additionally, the predominantly inattentive ADHD (ADHD-I) subtype lowered the odds of missed appointments (OR = 0.17; 95% CI, 0.050.62). Conclusion: Our results suggest that past behavior in terms of highest dropout rates in the educational and occupational systems and highest rates of skipping class during mandatory schooling is equally associated with current behavior of treatment dropout and missed appointments as are sociodemographic and clinical factors.

AB - Objective: Knowledge of factors associated with treatment dropout and missed appointments in adults with attention-deficit/ hyperactivity disorder (ADHD) is very limited. On the basis of proposed hypotheses that past behavior patterns are more predictive of current behaviors of treatment dropout and missed appointments than are sociodemographic and clinical characteristics, we examined the associations of sociodemographic variables, clinical variables, risk-taking behavior, educational and occupational instability, and behaviors during mandatory schooling with the primary outcome measures of treatment dropout and missed appointments. Method: In a naturalistic cohort study of 151 adult outpatients with ADHD initiating assessment in a Danish ADHD unit from September 1, 2010, to September 1, 2011, the Adult ADHD Self-Report Scale v1.1 symptom checklist (ASRS) and a thorough clinical interview were used to assess ADHD according to DSM-IV-TR criteria. Stepwise logistic regression analysis was used to estimate reported associations. Results: A total of 27% of patients dropped out of treatment and a total of 42% had ≥ 3 missed appointments during treatment. Mood and anxiety disorders significantly lowered the odds of treatment dropout (odds ratio [OR] = 0.18; 95% confidence interval [CI], 0.050.65), whereas having started but not completed 2 or more educational programs apart from mandatory schooling significantly increased the odds of dropout (OR = 3.01; 95% CI, 1.326.89). Variables significantly associated with most missed appointments were low educational level (OR = 2.19; 95% CI, 1.124.31), 3 or more employments of less than 3 months' duration (OR = 2.86; 95% CI, 1.306.28), and having skipped class often/very often during mandatory schooling (OR = 2.65; 95% CI, 1.295.43). Additionally, the predominantly inattentive ADHD (ADHD-I) subtype lowered the odds of missed appointments (OR = 0.17; 95% CI, 0.050.62). Conclusion: Our results suggest that past behavior in terms of highest dropout rates in the educational and occupational systems and highest rates of skipping class during mandatory schooling is equally associated with current behavior of treatment dropout and missed appointments as are sociodemographic and clinical factors.

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U2 - 10.4088/JCP.14m09270

DO - 10.4088/JCP.14m09270

M3 - Journal article

C2 - 26761266

SN - 0160-6689

VL - 77

SP - 232

EP - 239

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

IS - 2

ER -

Treatment drop-out and missed appointments among adults with Attention-Deficit/Hyperactivity Disorder (ADHD): Associations with patient- and disorder-related factors.

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