A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials

Dixon, Lucas J; Linardon, Jake

doi:10.1080/16506073.2019.1620324

Cited by 86Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials

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Dixon, Lucas J, Linardon, Jake·2020·Cognitive Behaviour Therapy

DOI 10.1080/16506073.2019.1620324

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Abstract

Dropout is an important factor that may compromise the validity of findings from randomized controlled trials (RCTs) of dialectical behaviour therapy (DBT). We conducted a targeted meta-analytic review of dropout from RCTs of DBT, with the aims of (1) calculating average rates of dropout from DBT; (2) investigating factors that moderate dropout; (3) examining whether dropout rates from DBT differ to control interventions; (4) synthesising reasons for dropout. Forty RCTs of DBT met full inclusion criteria. The weighted mean dropout rate was 28.0% (95% CI = 23.6, 32.9). Dropout rates were not related to target disorder, dropout definition, delivery format, therapist experience, and therapist adherence. Unexpectedly, dropout rates were significantly higher in trials that offered telephone coaching and utilized a therapist consultation team. DBT dropout rates did not significantly differ to dropout rates from control interventions. Few trials reported reasons for dropout, and there was little consistency in the reported reasons. Findings suggest that over one in four patients drop out from DBT in RCTs. This review highlights the urgency for future trials to explicitly report detail pertaining to patient dropout, as this may assist in the development of strategies designed to prevent future dropouts in RCTs of DBT.

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The dropout rates observed in the sample were at the lower end of rates reported in other studies.
“The dropout rates we observed in our sample were at the lower end of rates reported in other studies (28, 29).”
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Additional file 2 of Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy
Wibbelink, C. J. M., Arntz, A. R., Grasman, R. P. P. P., Sinnaeve, R., Boog, M., Bremer, O. M. C., Dek, E. C. P., Alkan, S. G., James, C., Koppeschaar, A. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19129058
Additional file 3 of Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy
Wibbelink, C. J. M., Arntz, A. R., Grasman, R. P. P. P., Sinnaeve, R., Boog, M., Bremer, O. M. C., Dek, E. C. P., Alkan, S. G., James, C., Koppeschaar, A. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19129061
Additional file 4 of Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy
Wibbelink, C. J. M., Arntz, A. R., Grasman, R. P. P. P., Sinnaeve, R., Boog, M., Bremer, O. M. C., Dek, E. C. P., Alkan, S. G., James, C., Koppeschaar, A. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19129064
Additional file 1 of Towards optimal treatment selection for borderline personality disorder patients (BOOTS): a study protocol for a multicenter randomized clinical trial comparing schema therapy and dialectical behavior therapy
Wibbelink, C. J. M., Arntz, A. R., Grasman, R. P. P. P., Sinnaeve, R., Boog, M., Bremer, O. M. C., Dek, E. C. P., Alkan, S. G., James, C., Koppeschaar, A. M., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19129055
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Authors: Dixon, L. J., & Linardon, J.
Affiliations: Deakin University (AU)
Corresponding author: Linardon, Jake
ORCID: Dixon, Lucas J
Linardon, Jake
Venue: Cognitive Behaviour Therapy
Publisher: Informa UK Limited
Published: 2019-06-17
Volume: 49
Issue: 3
Pages: 181-196
ISSN: 1650-6073 (ISSN-L)
1651-2316
DOI: 10.1080/16506073.2019.1620324
OpenAlex: W2949565761
Cited by: 86
References: 63
Citations by year: 2026: 15 · 2025: 14 · 2024: 16 · 2023: 13 · 2022: 15 · 2021: 7 · 2020: 6
FWCI: 1.11
Type: journal article
Language: en
Open access: green
figshare.com
Licence: cc-by
Locations: Cognitive Behaviour Therapy (publishedVersion)
PubMed (publishedVersion)
Figshare (submittedVersion, cc-by)
Funders: not receive
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: dialectical behavior therapy, treatment discontinuation, dropout rates, randomized controlled trials, telephone coaching, causes of dropout, medication adherence, therapist experience
MeSH terms: Dialectical Behavior Therapy, Humans, Patient Dropouts, Randomized Controlled Trials as Topic

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A systematic review and meta-analysis of dropout rates from dialectical behaviour therapy in randomized controlled trials

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