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Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London
Section of Epidemiology and General Practice, Institute of Psychiatry, London
Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London
Declaration of interest Funding from the NHS Executive.
Correspondence: Dr Sube Banerjee, Section of Epidemiology and General Practice, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
Background Psychiatric clinics have high non-attendance rates and failure to attend may be a sign of deteriorating mental health.
Aims To investigate why psychiatric out-patients fail to attend, and the outcome of attenders and non-attenders.
Method Prospective cohort study of randomly selected attenders and non-attenders at general adult psychiatric out-patient clinics. Subjects were interviewed at recruitment and severity of mental disorder and degree of social adjustment were measured. Six and 12 months later their engagement with the clinic and any psychiatric admissions were ascertained.
Results Of the 365 patients included in the study, 30 were untraceable and 224 consented to participate. Follow-up patients were more psychiatrically unwell than new patients. For follow-up patients, non-attenders had lower social functioning and more severe mental disorder than those who attended. At 12-month follow-up patients who missed their appointment were more likely to have been admitted than those who attended.
Conclusions Those who miss psychiatric follow-up out-patient appointments are more unwell and more poorly socially functioning than those who attend. They have a greater chance of drop-out from clinic contact and subsequent admission.
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