Skip to main content
Top
Published in: European Child & Adolescent Psychiatry 8/2006

01-12-2006 | ORIGINAL CONTRIBUTION

Evaluating mental health services in a Greek community

The factor of non-compliance to therapy

Authors: Dimitris C. Anagnostopoulos, Maria Vlassopoulos, Helen Lazaratou, Chara Tzavara, George Zelios, Dimitris Ploumpidis

Published in: European Child & Adolescent Psychiatry | Issue 8/2006

Login to get access

Abstract

This study aims to evaluate rendered mental health services for children and adolescents through the investigation of those factors which are related to non-compliance with therapy and which affect treatment outcome. Data were collected from the files of all new cases who applied to a Community Mental Health Centre in Athens during 2000–2002 (N = 363). For each case, the following factors were examined: age, sex, family situation, parents’ educational level, referral source, child’s psychiatric and psychosocial diagnoses, type of proposed therapy, phase at which termination of therapy occurred and outcome. Around 45.7% of the sample did not complete therapy. The probability of treatment compliance increased when the patient was male, with a diagnosis of a specific developmental disorder, treated in a well-structured therapy programme, was from a healthy family environment and his mother was better educated. On the contrary, an adverse family situation (one-parent family, inadequate parental supervision) and the female sex had a negative association with treatment compliance. Most of the cases discontinued their treatment upon completion of the diagnostic procedure. Referral source did not influence treatment compliance. Evaluation of our service has shown that more attention should be paid to less-educated families and those in adverse situations, particularly when the patient is female.
Literature
1.
go back to reference Abella A, Dufresne P, Gex Fabry M, et al. (2000) L’effet Pygmalion en pédopsychiatrie: relations entre les prédictions des cliniciens et les ruptures de traitement. Une étude prospective. Neuropsychiatrie de l’ Enfance et d’Adolescence 48:14–24 Abella A, Dufresne P, Gex Fabry M, et al. (2000) L’effet Pygmalion en pédopsychiatrie: relations entre les prédictions des cliniciens et les ruptures de traitement. Une étude prospective. Neuropsychiatrie de l’ Enfance et d’Adolescence 48:14–24
2.
go back to reference Bekker FJ, Hentschel U, Fujita M (1996) Basic cultural values and differences in attitudes toward health, illness and treatment preferences within a psychosomatic frame of reference. Psychotherapy and Psychosomatics 65:191–198PubMed Bekker FJ, Hentschel U, Fujita M (1996) Basic cultural values and differences in attitudes toward health, illness and treatment preferences within a psychosomatic frame of reference. Psychotherapy and Psychosomatics 65:191–198PubMed
3.
go back to reference Bickman L, Andrade AR, Lambert EW (2002) Dose response in child and adolescent mental health services. Journal of Mental Health Services Research 4:57–70CrossRef Bickman L, Andrade AR, Lambert EW (2002) Dose response in child and adolescent mental health services. Journal of Mental Health Services Research 4:57–70CrossRef
4.
go back to reference Bickman L, Summerfel WT, Noser K (1997) Comparative outcomes of emotionally disturbed children and adolescents in a system of services and usual care. Psychiatric Services 48:1543–1548PubMed Bickman L, Summerfel WT, Noser K (1997) Comparative outcomes of emotionally disturbed children and adolescents in a system of services and usual care. Psychiatric Services 48:1543–1548PubMed
5.
go back to reference Blanz B, Schmidt MH (2000) Practitioner review: preconditions and outcome of inpatient treatment in child and adolescent psychiatry. Journal of Child Psychology and Psychiatry and Allied Disciplines 41:703–712 Blanz B, Schmidt MH (2000) Practitioner review: preconditions and outcome of inpatient treatment in child and adolescent psychiatry. Journal of Child Psychology and Psychiatry and Allied Disciplines 41:703–712
6.
go back to reference Bourgeois ML, Koleck M, Roig-Morrier R (2002) Mesure de la conscience du trouble chez 100 malades hospitalises en psychiatrie. Annales Medico-Psychologiques 160:444–450CrossRef Bourgeois ML, Koleck M, Roig-Morrier R (2002) Mesure de la conscience du trouble chez 100 malades hospitalises en psychiatrie. Annales Medico-Psychologiques 160:444–450CrossRef
7.
go back to reference Brezinka (2002) Behavior therapy in children with conduct disorder. Zeitschrift für Kinder und Jugendpsychiatrie und Psychotherapie 30:41–50PubMedCrossRef Brezinka (2002) Behavior therapy in children with conduct disorder. Zeitschrift für Kinder und Jugendpsychiatrie und Psychotherapie 30:41–50PubMedCrossRef
8.
go back to reference Buchanan A (1992) A two-year prospective study of treatment compliance in patients with schizophrenia. Psychological Medicine 22:787–797PubMedCrossRef Buchanan A (1992) A two-year prospective study of treatment compliance in patients with schizophrenia. Psychological Medicine 22:787–797PubMedCrossRef
9.
go back to reference Capes J (1973) Evaluating services for adolescents, In: Wing JK, Hafner H (eds) Roots of evaluation: the epidemiological basis for planning psychiatric services, Oxford University Press, London Capes J (1973) Evaluating services for adolescents, In: Wing JK, Hafner H (eds) Roots of evaluation: the epidemiological basis for planning psychiatric services, Oxford University Press, London
10.
go back to reference Carpenter PJ, Range LM (1982) Predicting psychotherapy duration from therapists’ sex, professional affiliation, democratic values and community mental health ideology. Journal of Clinical Psychology 38:90–91PubMed Carpenter PJ, Range LM (1982) Predicting psychotherapy duration from therapists’ sex, professional affiliation, democratic values and community mental health ideology. Journal of Clinical Psychology 38:90–91PubMed
11.
go back to reference Centorrino F, Hernan MA, Drago-Ferrante G (2001) Factors associated with noncompliance with psychiatric outpatient visits. Psychiatric Services 52:378–380PubMedCrossRef Centorrino F, Hernan MA, Drago-Ferrante G (2001) Factors associated with noncompliance with psychiatric outpatient visits. Psychiatric Services 52:378–380PubMedCrossRef
12.
go back to reference Colom F, Vieta E, Martinez Aran A (2000) Clinical factors associated with treatment noncompliance in euthymic bipolar patients. Journal of Clinical Psychiatry 61:549–555PubMed Colom F, Vieta E, Martinez Aran A (2000) Clinical factors associated with treatment noncompliance in euthymic bipolar patients. Journal of Clinical Psychiatry 61:549–555PubMed
13.
go back to reference Cottrell D, Hill P, Walk D (1998) Factors influencing non-attendance at Child Psychiatry Out-Patient Appointments. British Journal of Psychiatry 152:201–204CrossRef Cottrell D, Hill P, Walk D (1998) Factors influencing non-attendance at Child Psychiatry Out-Patient Appointments. British Journal of Psychiatry 152:201–204CrossRef
14.
go back to reference Cramer JA, Rosenheck R (1998) Compliance with medications regimens for mental and physical disorders. Psychiatric Services 49:196–201PubMed Cramer JA, Rosenheck R (1998) Compliance with medications regimens for mental and physical disorders. Psychiatric Services 49:196–201PubMed
15.
go back to reference Eltz MJ, Shirk SR, Sarlin N (1995) Alliance formation and treatment outcome among maltreated adolescents. Child Abuse and Neglect 19:419–431PubMedCrossRef Eltz MJ, Shirk SR, Sarlin N (1995) Alliance formation and treatment outcome among maltreated adolescents. Child Abuse and Neglect 19:419–431PubMedCrossRef
16.
go back to reference Fenton WS, Blyer CR, Heinssen R (1997) Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin 23:637–651PubMed Fenton WS, Blyer CR, Heinssen R (1997) Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophrenia Bulletin 23:637–651PubMed
17.
go back to reference Gavin LA, Wamboldt MZ, Sorokin N (1999) Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma. Journal of Pediatric Psychology 24:355–365PubMedCrossRef Gavin LA, Wamboldt MZ, Sorokin N (1999) Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma. Journal of Pediatric Psychology 24:355–365PubMedCrossRef
18.
go back to reference Gewirtz A, Gossart Walker S (2000) Home – based treatment for children and families affected by HIV and AIDS. Dealing with stigma, secrecy, disclosure and loss. Child and Adolescent Psychiatry Clinics of North America 9:313–330 Gewirtz A, Gossart Walker S (2000) Home – based treatment for children and families affected by HIV and AIDS. Dealing with stigma, secrecy, disclosure and loss. Child and Adolescent Psychiatry Clinics of North America 9:313–330
19.
go back to reference Gould MS, Shaffer MD, Kaplan D (1985) The characteristics of dropouts from a Child Psychiatry Clinic. Journal of American Academy of Child and Adolescent Psychiatry 24:316–328CrossRef Gould MS, Shaffer MD, Kaplan D (1985) The characteristics of dropouts from a Child Psychiatry Clinic. Journal of American Academy of Child and Adolescent Psychiatry 24:316–328CrossRef
20.
go back to reference Hack S, Chow B (2001) Pediatric psychotropic medication compliance: a literature review and research-based suggestions for improving treatment compliance. Journal of Child and Adolescent Psychopharmacology 11:59–67PubMedCrossRef Hack S, Chow B (2001) Pediatric psychotropic medication compliance: a literature review and research-based suggestions for improving treatment compliance. Journal of Child and Adolescent Psychopharmacology 11:59–67PubMedCrossRef
21.
go back to reference Harrington RC, Kerfoot M, Verduyn C (1999) Developing needs led child and adolescent mental health services: issues and prospects. European Child and Adolescent Psychiatry 8:1–10PubMedCrossRef Harrington RC, Kerfoot M, Verduyn C (1999) Developing needs led child and adolescent mental health services: issues and prospects. European Child and Adolescent Psychiatry 8:1–10PubMedCrossRef
22.
go back to reference Holden W, Friedman R, Santiago R (2001) Overview of the national evaluation of the comprehensive community mental health services for children and their families. Journal of Emotional and Behavioral Disorders 9:4–12CrossRef Holden W, Friedman R, Santiago R (2001) Overview of the national evaluation of the comprehensive community mental health services for children and their families. Journal of Emotional and Behavioral Disorders 9:4–12CrossRef
23.
go back to reference Horvath A, Luborsky L (1993) The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology 61:561–573PubMedCrossRef Horvath A, Luborsky L (1993) The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology 61:561–573PubMedCrossRef
24.
go back to reference Huffine C (2002) Child and adolescent psychiatry: current trends in the community treatment of seriously emotional disturbed youths. Psychiatric Services 53:809–811PubMedCrossRef Huffine C (2002) Child and adolescent psychiatry: current trends in the community treatment of seriously emotional disturbed youths. Psychiatric Services 53:809–811PubMedCrossRef
25.
go back to reference Hunter J, Higginson I, Garralda E (1996) Systematic literature review: outcome measures for child and adolescent mental health services. Journal of Public Health and Medicine 18:197–206 Hunter J, Higginson I, Garralda E (1996) Systematic literature review: outcome measures for child and adolescent mental health services. Journal of Public Health and Medicine 18:197–206
26.
go back to reference Kazdin A, Jennifer L, Mazurick M, Siegel T (1994) Treatment outcome among children with external disorder who terminate prematurely versus those who complete psychotherapy. Journal of American Academy of Child and Adolescent Psychiatry 33:4–9CrossRef Kazdin A, Jennifer L, Mazurick M, Siegel T (1994) Treatment outcome among children with external disorder who terminate prematurely versus those who complete psychotherapy. Journal of American Academy of Child and Adolescent Psychiatry 33:4–9CrossRef
27.
go back to reference Kazdin AΕ, Mazurick JL, Bass D (1993) Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology 22:2–16CrossRef Kazdin AΕ, Mazurick JL, Bass D (1993) Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology 22:2–16CrossRef
28.
go back to reference Kourani RFC, Garber J, Tornusciolo G (1990) Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of American Academy of Child and Adolescent Psychiatry 29:657–660CrossRef Kourani RFC, Garber J, Tornusciolo G (1990) Improving first appointment attendance rates in child psychiatry outpatient clinics. Journal of American Academy of Child and Adolescent Psychiatry 29:657–660CrossRef
29.
go back to reference Lazaratou H, Vlassopoulos M, Dellatolas G (2000) Factors affecting compliance with treatment in an outpatient Child Psychiatric Practice: a retrospective study in a Community Mental Health Center in Athens. Psychotherapy and Psychosomatics 69:42–49PubMedCrossRef Lazaratou H, Vlassopoulos M, Dellatolas G (2000) Factors affecting compliance with treatment in an outpatient Child Psychiatric Practice: a retrospective study in a Community Mental Health Center in Athens. Psychotherapy and Psychosomatics 69:42–49PubMedCrossRef
30.
go back to reference Lerner Y, Zilber N, Barasch M, Wittman L (1993) Utilization patterns of community mental health services by newly referred patients. Social Psychiatry and Psychiatric Epidemiology 28:7–22CrossRef Lerner Y, Zilber N, Barasch M, Wittman L (1993) Utilization patterns of community mental health services by newly referred patients. Social Psychiatry and Psychiatric Epidemiology 28:7–22CrossRef
31.
go back to reference Liakopoulou M, Protagora D, Hatzielefteriou M (1993) Consultation – Liaison Child Psychiatry: patient’s characteristics and reasons related to drop-out from follow-up. Psychiatry 5:38–41, (in Greek) Liakopoulou M, Protagora D, Hatzielefteriou M (1993) Consultation – Liaison Child Psychiatry: patient’s characteristics and reasons related to drop-out from follow-up. Psychiatry 5:38–41, (in Greek)
32.
go back to reference Lucas G, Mylona E (2002) ‘Etude différentielle des modes de cessation en consultations thérapeutiques et traitements á séances régulières. Psychiatrie de l’enfant: quels patients, quels traitements. Collt P.U.F., Paris Lucas G, Mylona E (2002) ‘Etude différentielle des modes de cessation en consultations thérapeutiques et traitements á séances régulières. Psychiatrie de l’enfant: quels patients, quels traitements. Collt P.U.F., Paris
33.
go back to reference Madianos M, Economou M, Papageorgiou A, Stefanis C (1995) The first Community Mental Health Center in Greece: fifteen years of integrated mental health care and psychosocial rehabilitation. International Journal of Psychosocial Rehabilitation 1:110–114 Madianos M, Economou M, Papageorgiou A, Stefanis C (1995) The first Community Mental Health Center in Greece: fifteen years of integrated mental health care and psychosocial rehabilitation. International Journal of Psychosocial Rehabilitation 1:110–114
34.
go back to reference Madianos M, Zarnari O (1998) Health and Greek Society. NSSC, Athens Madianos M, Zarnari O (1998) Health and Greek Society. NSSC, Athens
35.
go back to reference Marriage K, Petrie J, Worling D (2001) Consumer satisfaction with an adolescent inpatient psychiatric unit. Canadian Journal of Psychiatry 46:969–975 Marriage K, Petrie J, Worling D (2001) Consumer satisfaction with an adolescent inpatient psychiatric unit. Canadian Journal of Psychiatry 46:969–975
36.
go back to reference Mc Donald J, Brown N, Ellis P (2000) Using telephone prompts to improve initial attendance at a community mental health center. Psychiatric Services 51:812–814CrossRef Mc Donald J, Brown N, Ellis P (2000) Using telephone prompts to improve initial attendance at a community mental health center. Psychiatric Services 51:812–814CrossRef
37.
go back to reference Rey JM, Plapp JM, Simpson PL (1999) Parental satisfaction and outcome: a 4-year study in a child and adolescent mental health service. Australian and New Zealand Journal of Psychiatry 33:22–28PubMedCrossRef Rey JM, Plapp JM, Simpson PL (1999) Parental satisfaction and outcome: a 4-year study in a child and adolescent mental health service. Australian and New Zealand Journal of Psychiatry 33:22–28PubMedCrossRef
38.
go back to reference Riepe FG, Krone N, Viemann M (2002) Management of congenital adrenal hyperplasia. Results of the ESPE questionnaire. Hormones-Research 58:196–205CrossRef Riepe FG, Krone N, Viemann M (2002) Management of congenital adrenal hyperplasia. Results of the ESPE questionnaire. Hormones-Research 58:196–205CrossRef
39.
go back to reference Semansky RM, Koyanagi C (2003) Accessing Medicaid’s Child Mental Health Services: the experience of parents in two States. Psychiatric Services 54:475–476PubMedCrossRef Semansky RM, Koyanagi C (2003) Accessing Medicaid’s Child Mental Health Services: the experience of parents in two States. Psychiatric Services 54:475–476PubMedCrossRef
40.
go back to reference Slade M (2002) What outcomes to measure in routine mental health services and how to assess them: a systematic review. Australian and New Zealand Journal of Psychiatry 36:743–53PubMedCrossRef Slade M (2002) What outcomes to measure in routine mental health services and how to assess them: a systematic review. Australian and New Zealand Journal of Psychiatry 36:743–53PubMedCrossRef
41.
go back to reference Turgay A (1990) Treatment outcome for children and adolescents with conversion disorder. Canadian Journal of Psychiatry 35:585–589 Turgay A (1990) Treatment outcome for children and adolescents with conversion disorder. Canadian Journal of Psychiatry 35:585–589
42.
go back to reference Walk-on GO (1986) Patient compliance in the mental health continuum of care. Journal of Compliance in Health Care 1:75–89 Walk-on GO (1986) Patient compliance in the mental health continuum of care. Journal of Compliance in Health Care 1:75–89
Metadata
Title
Evaluating mental health services in a Greek community
The factor of non-compliance to therapy
Authors
Dimitris C. Anagnostopoulos
Maria Vlassopoulos
Helen Lazaratou
Chara Tzavara
George Zelios
Dimitris Ploumpidis
Publication date
01-12-2006
Publisher
Steinkopff-Verlag
Published in
European Child & Adolescent Psychiatry / Issue 8/2006
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-006-0554-3

Other articles of this Issue 8/2006

European Child & Adolescent Psychiatry 8/2006 Go to the issue