INTRODUCTION: The efficacy of psychoanalytic psychotherapy is well established in controlled clinical trials; however, some individual characteristics that predict better outcomes are yet poorly studied. This study aimed at evaluating the association of demographics data, psychiatric diagnosis, clinical impairment, quality of life, aspects of psychotherapy suitability, defensive style and dropout before 3 months. METHOD: A consecutive sample of 56 subjects was evaluated after psychotherapy indication through a standardized protocol, World Health Organization Quality of Life Bref (WHOQOL-Bref), Self Report Questionnaire, Defensive Style Questionnaire, Scale of Defensive Functioning of Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR) and Global Assessment of Functioning, and followed for 3 months. RESULTS: Dropout rate was 12.5%. There was no difference between groups in respect to Global Assessment of Functioning, Self Report Questionnaire and Defensive Style Questionnaire scores. Dropout patients reported to be satisfied with their health, despite psychopathological severity, even when other variables were controlled (p < 0.0001). The group that remained in psychotherapy was better adjusted before treatment and had average or superior estimated intelligence (p < 0.05). More dropout patients presented lower levels of defensive style, by means of the Scale of Defensive Functioning of DSM-IV-TR. CONCLUSIONS: Psychopathology severity alone did not predict dropout. However, patients with lower levels of insight and immature defenses (especially narcissistic) had higher dropout rates. Therefore, such aspects must be seriously considered, along with patients' expectations about the psychoanalytic method, and should be judiciously assessed before indication.
Psychotherapy; psychoanalysis; patient dropout; treatment outcome; defense mechanisms; quality of life
