ANN ARBOR, MI — Nearly half of veterans who discontinue treatment for depression end up going back within six months, with reengagement rates higher in those receiving both psychotherapy and antidepressant medications.
That’s according to a new study published in the General Hospital Psychiatry journal. Researchers sought to evaluate outcomes of veterans who discontinued treatment with at least moderate ongoing depressive symptoms.1
Veterans with elevated depression symptoms from 29 VA facilities completed baseline surveys and follow-up assessments for one year. Rates and predictors of treatment discontinuation, treatment reengagement and subsequent symptoms among patients who remained out of care were all assessed in analysis by researchers from the University of Michigan Medical School and the VA Ann Arbor, MI, Healthcare System. James A. Haley Veterans’ Hospital in Tampa also participated.
The study found that 242 of 1,259 (17.8%) participants discontinued treatment while symptomatic, with Black participants, participants with less severe depression and participants receiving only psychotherapy—not combined psychotherapy and antidepressant medications—discontinuing at higher rates.
Among all 445 participants who discontinued treatment, 45.8% reengaged within the following six months, with participants receiving combined treatment reengaging at higher rates. On the other hand, of the 112 participants who discontinued while symptomatic within the first six months of the study and did not return to care, 68.8% remained symptomatic at 12 months. Associated with remaining symptomatic while untreated were lower baseline treatment expectancy and greater depression symptom severity, the study pointed out.
“Black race, lower symptom severity, and treatment modality may help identify patients at higher risk for discontinuing care while symptomatic, whereas patients with lower treatment expectations may be at greater risk for remaining out of care despite continuing symptoms,” the researchers concluded.
- Saulnier KG, Panaite V, Ganoczy D, Kim HM, Zivin K, Hofer T, Piette JD, Pfeiffer PN. Depression symptom outcomes and re-engagement among VA patients who discontinue care while symptomatic. Gen Hosp Psychiatry. 2023 Oct 14;85:87-94. doi: 10.1016/j.genhosppsych.2023.10.008. Epub ahead of print. PMID: 37862961.