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Prediction of twelve‐month service disengagement from an early intervention in psychosis service
Author(s) -
Turner Mark,
SmithHamel Cecilia,
Mulder Roger
Publication year - 2007
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/j.1751-7893.2007.00039.x
Subject(s) - disengagement theory , psychosis , psychiatry , intervention (counseling) , psychology , clinical psychology , mood , logistic regression , referral , medicine , schizophrenia (object oriented programming) , gerontology , family medicine
Aim: The aim is to examine disengagement in an early psychosis treatment service and contrast clinical and demographic variables of patients who disengage against those who do not. Methods: Those with termination of treatment, despite therapeutic need within 12 months of entry (disengagers) ( n = 57; 24.6%), were compared with those who remained in treatment at 12 months ( n = 175) on a range of clinical and demographic variables collected at admission. After testing the difference between proportions, data analysis was conducted using methods of logistic regression. Results: Alcohol and/or cannabis abuse/dependence, initial diagnosisother than mood disorder, long duration of untreated psychosis, lower Positive and Negative Syndrome Scale total symptoms, and lower insight at referral accounted for 27% of variance in patient ‘disengagement’ within 12 months. Conclusion: A significant proportion of patients with first episode psychosis disengage from treatment within 12 months. Despite a number of factors being associated with disengagement, prediction using admission factors was poor. Early Intervention in Psychosis Services would benefit from increased attention to alcohol and drug problems, trying to reduce the duration of untreated psychosis, improving psychiatric symptoms and increasing insight in all patients to decrease service disengagement.