Dropout rates among patients attending child and adolescent psychiatry services of a tertiary care center: A retrospective study from north India

Background: Little information is available about dropout from treatment for children and adolescents attending the various psychiatric services. Aim: This study aimed to evaluate the drop-out rates of patients attending child and adolescent psychiatry services. Methods: A retrospective review of 2249 case records of all patients aged up to 15 years registered in child and adolescent psychiatry services from 1st January 2017 to 31st December 2018 was carried out. Details regarding socio-demographic data, clinical data and follow up status were extracted from the records. Results: The mean age of the study sample was 11.11(SD: 3.58) years. About two-fifth (n=1003; 43.99 %) did not follow up at all after the first walk-in contact. Additionally, about one-tenth (n=247; 11 %) dropped out by the one month of the first contact, another one eighth (n=275; 12.2 %) dropped out by 3 months of the first contact with outpatient services and another one-eighth (n=301; 13.4%) dropped out of the follow-up by 6 months of the first contact. Only one-fifth (n=423; 18.8%) of the patients followed up beyond 6 months of the first walk-in contact. No significant difference was noted between those who continued to follow-up and those who dropped out in terms of age group, gender, and the number of diagnoses made at the initial evaluation. Those who dropped out of treatment were less often prescribed medications in the form of antipsychotics or antidepressants. Conclusion: This study shows that there is a high dropout rate from the child and adolescent psychiatric outpatient services. Accordingly, strategies need to be developed to minimize dropout rates.