Predictors of disengagement from Early Intervention in Psychosis services

The British Journal of Psychiatry : the Journal of Mental Science
Francesca SolmiJames B Kirkbride

Abstract

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. 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. 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. 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.

References

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Citations

Sep 30, 2019·Community Mental Health Journal·Grace JaggerJesus Perez
Oct 28, 2019·Social Psychiatry and Psychiatric Epidemiology·Letizia LeanzaAnita Riecher-Rössler
Sep 26, 2020·Behavioural and Cognitive Psychotherapy·Guy DodgsonCharles Fernyhough
Mar 30, 2019·Social Psychiatry and Psychiatric Epidemiology·Da Jung KimBrian O'Donoghue
Nov 26, 2020·Psychiatric Services : a Journal of the American Psychiatric Association·Franco MascayanoLisa B Dixon
Jan 13, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Nev JonesMichael T Compton

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