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Predictors of disengagement from Early Intervention in Psychosis services.

Published version
Peer-reviewed

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Authors

Solmi, Francesca 
Mohammadi, Abdolali 
Perez, Jesus A 
Jones, Peter B 

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.AimsTo 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.Declaration of interestNone.

Description

Keywords

Early intervention services, SEPEA, Social Epidemiology of Psychosis in East Anglia, cohort study, psychosis, Adolescent, Adult, Cohort Studies, Early Diagnosis, Early Medical Intervention, Female, Humans, Logistic Models, Male, Multivariate Analysis, Patient Compliance, Predictive Value of Tests, Proportional Hazards Models, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenic Psychology, Severity of Illness Index, Treatment Outcome, United Kingdom, Young Adult

Journal Title

Br J Psychiatry

Conference Name

Journal ISSN

0007-1250
1472-1465

Volume Title

213

Publisher

Royal College of Psychiatrists
Sponsorship
Wellcome Trust (085540/Z/08/Z)
National Institute for Health and Care Research (RP-PG-0606-1335)