Academic Journal
Factors Influencing Treatment Dropout Among Child and Adolescent Psychiatric Patients: A Survival Analysis.
| Title: | Factors Influencing Treatment Dropout Among Child and Adolescent Psychiatric Patients: A Survival Analysis. |
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| Authors: | Sasaki Y; Institute of Science Tokyo Graduate School, Tokyo, Japan. ysfppsyc@tmd.ac.jp.; Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan. ysfppsyc@tmd.ac.jp., Usami M; Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan., Hakosima Y; Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan., Inazaki K; Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan., Mizumoto Y; Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan., Ito M; National Center of Neurology and Psychiatry, Kodaira, Japan., Mikami K; Tokai University School of Medicine, Kanagawa, Japan., Tsujii N; Toyama University Hospital, Toyama, Japan., Okada T; Institute of Science Tokyo Graduate School, Tokyo, Japan., Takahashi H; Institute of Science Tokyo Graduate School, Tokyo, Japan.; Institute of Science, Tokyo Centre for Brain Integration Research, Institute of Biomedical Engineering, Tokyo, Japan. |
| Source: | Journal of clinical psychology in medical settings [J Clin Psychol Med Settings] 2026 Sep; Vol. 33 (3), pp. 509-518. Date of Electronic Publication: 2026 Jun 11. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: United States NLM ID: 9435680 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-3572 (Electronic) Linking ISSN: 10689583 NLM ISO Abbreviation: J Clin Psychol Med Settings Subsets: MEDLINE |
| Imprint Name(s): | Publication: New York, NY : Springer Original Publication: New York, NY : Plenum Press, c1994- |
| MeSH Terms: | Patient Dropouts*/statistics & numerical data , Patient Dropouts*/psychology , Mental Disorders*/therapy , Mental Disorders*/drug therapy, Divorce/statistics & numerical data ; Humans ; Female ; Adolescent ; Child ; Retrospective Studies ; Male ; Japan ; Survival Analysis ; Risk Factors |
| Abstract: | Child and adolescent mental health disorders are a significant global health concern, with high rates of treatment dropout adversely affecting long-term outcomes. This retrospective cohort study aimed to identify factors influencing treatment dropout in child and adolescent psychiatric patients. 443 outpatients aged < 15 years who visited a specialized child and adolescent psychiatry outpatient clinic at a national medical center in Japan between April 2022 and March 2023 were followed for 1 year. Dropout was defined as failure to attend scheduled appointments without notice or having no record of visits for more than 6 months after the last visit. Of the 443 patients, 74 (16.7%) dropped out within 1 year. Parental divorce or separation increased dropout risk (odds ratio [OR] = 2.28, 95% confidence interval [CI]: 1.05-5.10, p < 0.05), whereas receiving a prescription at the initial visit decreased risk (OR = 0.27, 95% CI: 0.10-0.76, p < 0.05; hazard ratio = 0.28, 95% CI: 0.12-0.65, p < 0.01). The Kaplan-Meier analysis revealed higher 1-year retention rates for patients receiving initial prescriptions (93 vs. 79%), particularly among females (98 vs. 79%). Early pharmacological interventions and identification of high-risk family constellations may enhance treatment retention in child and adolescent psychiatry. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: Yoshinori Sasaki, Masahide Usami, Yuki Hakosima, Kumi Inazaki, Yuki Mizumoto, Masaya Ito, Katsunaka Mikami, Noa Tsujii, Takayuki Okada and Hidehiko Takahashi have not disclosed any competing interests. Ethical Approval: This study was approved by the institutional ethics committee and was conducted in accordance with the principles of the Declaration of Helsinki and future amendments. Written or verbal informed consent was not required, as the study was conducted in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects of Japan. Consent to Participate: The guidelines specify that obtaining informed consent from participants is not always necessary. However, for observational studies that utilize only past clinical records and non-human tissue samples, researchers must publish information regarding the study’s implementation, including its purpose. The study purpose, methods, analyses, and details on how to refuse participation were posted in the outpatient clinic and on the hospital’s website, in accordance with national ethical guidelines. Use of Generative AI: The authors used a generative artificial intelligence tool to assist with language editing and phrasing of the manuscript. All content was critically reviewed, verified, and approved by the authors, who are fully responsible for the final version of the manuscript. |
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| Grant Information: | JP25K19074 JSPS KAKENHI; 24A1014 NCGM Intramural Research Fund |
| Contributed Indexing: | Keywords: Child psychiatry; Divorce; Drug prescriptions; Survival analysis; Treatment dropouts |
| Entry Date(s): | Date Created: 20260611 Date Completed: 20260916 Latest Revision: 20260919 |
| Update Code: | 20260919 |
| PubMed Central ID: | PMC13582214 |
| DOI: | 10.1007/s10880-026-10159-8 |
| PMID: | 42274894 |
| Database: | MEDLINE |
| ISSN: | 1573-3572 |
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| DOI: | 10.1007/s10880-026-10159-8 |