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Early termination of treatment in personality disorder treated in a psychotherapy hospital

Quantitative and qualitative study

Research Unit, The Cassel Hospital, Richmond, Surrey

Correspondence: Dr M. Chiesa, Research Unit, The Cassel Hospital, I Ham Common, Richmond, Surrey TW107JF. e-mail: marco{at}cassel.ftech.co.uk

Declaration of interest This study was funded by a grant from the Sir Jules Thorn Charitable Trust.

See editorial, pp. 93-94, this issue.

Background Factors underlying premature discontinuation of psychosocial in-patient treatment are still unclear.

Aims Investigation of early discontinuation of specialised in-patient psychosocial treatment in a sample of people with personality disorder.

Method Out of 134 consecutive admissions to the Cassel Hospital, 42 early drop-outs and 92 patients who remained were compared on demographic and clinical variables. Early drop-outs were invited for in-depth interviews, to explore their hospital experiences.

Results The early drop-out group and the group which remained showed significant differences in occupational status, borderline personality disorder (BPD) and the treatment programme to which they were allocated. All three independent variables predicted early discontinuation of treatment. The qualitative analysis of interview transcripts identified significant problems in institutional dimensions.

Conclusions Important subjects and process variables contributing to early drop-out in people with personality disorder were identified, with potential implications for clinical practice.

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