Predictors of disengagement from Early Intervention in Psychosis services

Francesca Solmi, Abdolali Mohammadi, Jesus A. Perez, Yasir Hameed, Peter B. Jones, James B. Kirkbride

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)
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Abstract

Background: The effectiveness of Early Intervention in Psychosis (EIP) services for individuals with a first episode of psychosis (FEP) could be thwarted by high rates of early disengagement.

Aims: To investigate which factors predict disengagement with EIP services.

Method: Using data from a naturalistic cohort of 786 EIP clients in East Anglia (UK), we investigated the association between sociodemographic and clinical predictors and disengagement using univariable and multivariable Cox proportional hazards models.

Results: Over half (54.3%) of our sample were discharged before receiving 3 years of EIP care, with 92 (11.7%) participants discharged due to disengagement. Milder negative symptoms, more severe hallucinations, not receiving an FEP diagnosis, polysubstance use and being employed were associated with greater disengagement.

Conclusions: Our findings highlight heterogeneous reasons for disengagement with EIP services. For some patients, early disengagement may hinder efforts to sustain positive long-term EIP outcomes. Efforts to identify true FEP cases and target patients with substance use problems and more severe positive symptoms may increase engagement.

(C) The Royal College of Psychiatrists 2018.
Original languageEnglish
Pages (from-to)477-483
Number of pages7
JournalThe British Journal of Psychiatry
Volume213
Issue number2
Early online date21 May 2018
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Early intervention services
  • psychosis
  • cohort study
  • Social Epidemiology of Psychosis in East Anglia
  • SEPEA
  • RANDOMIZED CONTROLLED-TRIAL
  • 1ST-EPISODE PSYCHOSIS
  • PROGRAM
  • CARE
  • DETERMINANTS
  • RELIABILITY
  • ENGAGEMENT
  • DURATION
  • PATHWAYS
  • ILLNESS

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