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Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: The predictD-Spain study
  1. Juan Angel Bellón1,*,
  2. Juan de Dios Luna2,
  3. Berta Moreno3,
  4. Carmen Montón-Franco4,
  5. María Josefa GildeGómez-Barragán5,
  6. Marta Sánchez-Celaya6,
  7. Miguel Ángel Díaz-Barreiros7,
  8. Catalina Vicens8,
  9. Emma Motrico9,
  10. María Teresa Martínez-Cañavate10,
  11. Bárbara Olivan-Blázquez11,
  12. Ana Vázquez-Medrano12,
  13. María Soledad Sánchez-Artiaga13,
  14. Sebastià March14,
  15. María del Mar Muñoz-García15,
  16. Patricia Moreno-Peral16,
  17. Irwin Nazareth17,
  18. Michael King18,
  19. Francisco Torres-González19
  1. 1 C.S. El Palo. Unidad de Investigación del Distrito Málaga. Dpto. M. Preventiva.Universidad de Málaga, Spain;
  2. 2 Departamento de Bioestadística. Universidad de Granada, Spain;
  3. 3 Unidad de Investigación del Distrito Málaga. Facultad de Psicología. Universidad de Málaga, Spain;
  4. 4 C.S. Casablanca. Dpto Medicina y Psiquiatría. Universidad de Zaragoza., Spain;
  5. 5 Unidad Docente de Medicina Familiar y Comunitaria de la Rioja, Spain;
  6. 6 Unidad Docente de Medicina Familiar del Área 1 de Madrid, Spain;
  7. 7 C.S. Vecindario. Servicio Canario de Salud. Las Palmas, Spain;
  8. 8 C.S. son Serra-La Vileta. Unidad Docente de Medicina Familiar y Comunitaria de Mallorca., Spain;
  9. 9 Unidad de Investigación del Distrito Málaga. Facultad de Psicología. Universidad de Málaga., Spain;
  10. 10 Fundación IAVANTE, Granada., Spain;
  11. 11 Unidad de Investigación de Atención Primaria. Instituto Aragonés de Ciencias de la Salud, Zaragoza., Spain;
  12. 12 Unidad Docente de Medicina Familiar y Comunitaria de La Rioja, Spain;
  13. 13 C.S. Condes de Barcelona-Boadilla, Área 6 de Atención Primara, Madrid, Spain;
  14. 14 Unidad de Investigación de Atención Primaria de Baleares. Mallorca, Spain;
  15. 15 Departamento de Psiquiatría y Medicina legal. Universidad de Granada, Spain;
  16. 16 Unidad de Investigación del Distrito Málga., Spain;
  17. 17 Medical Research Council General Practice Research Framework, United Kingdom;
  18. 18 Department of Mental Health Sciences, UCL, United Kingdom;
  19. 19 Departamento de Psiquiatría. Universidad de Granada, Spain
  1. To whom correspondence should be addressed. E-mail: jabellon{at}terra.es

Abstract

Background: Few data exist on the psychosocial factors associated with attrition in longitudinal surveys. We aim to determine psychosocial and sociodemographic predictors of attrition from a longitudinal study of the onset and persistence of episodes of major depression in primary care.

Methods: A systematic random sample of general practice attendees was recruited in seven Spanish provinces between October 2005 and February 2006. Major depression was diagnosed using the Composite International Diagnostic Interview and a set of 39 individual and environmental risk factors for depression were assessed at baseline and after 6 and 12 months of follow-up. We used multilevel logistic regression.

Results: We selected 7,777 primary care attendees aged 18-75 years, of whom 1,251 (16.1%) were excluded. Of the remaining 6,526, 1,084 (16.6%) refused to participate. Thus, 5,442 patients (attending 231 family physicians in 41 health centers) were interviewed at baseline, of whom 3,804 (70%) and 3,567 (66%) remained at 6 and 12 months of follow-up, respectively. The province and sociodemographic factors were stronger predictors of attrition than psychosocial factors. Depression and anxiety had no effect but other psychosocial factors affected attrition. We also found different profiles for the patients lost at 12 months when we included predictors measured at baseline versus 6 months.

Conclusions: These findings suggest several psychosocial factors might be considered factors of attrition in primary care cohorts and confirm that baseline characteristics are insufficient for analysing non-response in longitudinal studies, suggesting that different retention strategies should be applied for patients interviewed at 6 and 12 months.

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