Factors Associated with Adherence to Follow-up Among Patients with Depressive Disorders in a Collaborative Care Program in Iran

Background: Despite effective treatments are available for depressive disorders, less than half of patients utilize them and the treatment gap is large. Objectives: This study aimed to investigate factors associated with adherence to follow-up in patients diagnosed with a depressive disorder in the collaborative care program in Tehran between May 2017 to October 2017. Methods: A retrospective cross-sectional study was performed in three community mental health centers (CMHCs) in Tehran. Results: A total of 435 cases were recruited, and their adherence to follow-up rate was 41.6%. According to multivariate regression, being visited in a particular center, having a high school or higher level of education, having a positive family history with effective treatment, taking selective serotonin reuptake inhibitors (SSRIs), experiencing a lower level of perceived mental health before the first visit, and referral to a psychiatrist could predict adherence to follow-up. Patients who had a chief complaint of typical depressive symptoms and those who were employed were less likely to be adherent to follow-up. Conclusions: More population-based studies in various settings and cultures are needed to enhance our knowledge regarding interventions necessary to deliver quality care to depressed patients.