Solmi, F; Mohammadi, A; Perez, JA; Hameed, Y; Jones, PB; Kirkbride, JB; (2018) Predictors of disengagement from Early Intervention in Psychosis services in the UK. The British Journal of Psychiatry , 213 (2) pp. 477-483. 10.1192/bjp.2018.91.

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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. Declaration of interest: None.

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