Predictors of Dropout from Outpatient Mental Health Services

Sir,

We thank the reader for a critical reading and expressing valid concerns related with the methodology. The first concern raised is about the limited sample size, which is a genuine one and has already been considered as a shortcoming.[1] It must be remembered that the given study was not funded and the authors had limited resources at their disposal. Hence, it was decided to include every tenth patient who attended the hospital. A mindful compromise between the resources available and the research question that needs to be answered was done.

The second concern is regarding the arbitrary classification among illiterates. We recorded gradients of education level, and when we ran statistical models, we found that people who received no formal education were less likely to dropout from the treatment at 6 months than people who received any formal education, as has been reported in the study. For the sake of brevity, we categorized the data into statistically meaningful categories.

Further, more research is needed to replicate and find reasons for this counter-intuitive result. We have made two speculations that are open to hypothesis-based testing. The author of the letter, we presume, is also only making hypothesis about inability to afford cost of treatment, indicating poor socioeconomic status. They will also need to be tested.