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Brief Reports   |    
Rate and Predictors of Service Disengagement Among Patients With First-Episode Psychosis
Shushan Zheng, M.B.B.S.; Lye Yin Poon, B.Soc.Sci., M.B.A.; Swapna Verma, M.B.B.S., M.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200199
View Author and Article Information

Dr. Zheng is affiliated with the National Psychiatry Residency Program, NHG-AHPL Residency, Ren Ci Community Hospital, Singapore (e-mail: shushan.zheng@mohh.com.sg). She is also with the Early Psychosis Intervention Program, Institute of Mental Health, Woodbridge Hospital, 10 Buangkok View, Singapore 539 747, where Ms. Poon and Dr. Verma are affiliated.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  This study determined the rate of service disengagement among patients in the Early Psychosis Intervention Program (EPIP) in Singapore and predictors of disengagement.

Methods  EPIP is a two-year multidisciplinary program targeting first-episode psychosis. The sample comprised patients consecutively accepted (2001–2009) who had two years of follow-up data. Disengagement was assessed with a semistructured scale. Sociodemographic and clinical variables were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders, the Positive and Negative Syndrome Scale, and the Global Assessment of Functioning. Regression analyses were conducted.

Results  Among 775 patients, 109 (14%) disengaged from EPIP within two years. Significant baseline predictors included Malay ethnicity (odds ratio [OR]=1.93, 95% confidence interval [CI]=1.12–3.29) and less than six years of education (OR=2.30, CI=1.23–4.29).

Conclusions  EPIP’s engagement strategy should focus on patients of Malay ethnicity and of low educational attainment. Further studies should examine how these factors affect service disengagement.

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Table 1Multivariate analysis of predictors of service disengagement among patients in the Early Psychosis Intervention Program
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a Tertiary, polytechnic or university education

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References

Chong  SA;  Lee  C;  Bird  L  et al:  A risk reduction approach for schizophrenia: the Early Psychosis Intervention Programme.  Annals of the Academy of Medicine, Singapore 33:630–635, 2004
[PubMed]
 
Rossi  A;  Amaddeo  F;  Bisoffi  G  et al:  Dropping out of care: inappropriate terminations of contact with community-based psychiatric services.  British Journal of Psychiatry 181:331–338, 2002
[CrossRef] | [PubMed]
 
Turner  MA;  Smith-Hamel  C;  Mulder  RT:  Prediction of twelve-month service disengagement from an early intervention in psychosis service.  Early Intervention in Psychiatry 1:276–281, 2007
[CrossRef]
 
Conus  P;  Lambert  M;  Cotton  S  et al:  Rate and predictors of service disengagement in an epidemiological first-episode psychosis cohort.  Schizophrenia Research 118:256–263, 2010
[CrossRef] | [PubMed]
 
Stowkowy  J;  Addington  D;  Liu  L  et al:  Predictors of disengagement from treatment in an early psychosis program.  Schizophrenia Research 136:7–12, 2012
[CrossRef] | [PubMed]
 
Tait  L;  Birchwood  M;  Trower  P:  Predicting engagement with services for psychosis: insight, symptoms and recovery style.  British Journal of Psychiatry 182:123–128, 2003
[CrossRef] | [PubMed]
 
Lecomte  T;  Spidel  A;  Leclerc  C  et al:  Predictors and profiles of treatment non-adherence and engagement in services problems in early psychosis.  Schizophrenia Research 102:295–302, 2008
[CrossRef] | [PubMed]
 
O’Brien  A;  Fahmy  R;  Singh  SP:  Disengagement from mental health services. A literature review.  Social Psychiatry and Psychiatric Epidemiology 44:558–568, 2009
[CrossRef] | [PubMed]
 
First  MB;  Spitzer  RL;  Gibbon  M  et al (eds):  Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) .  Washington, DC,  American Psychiatric Press, Inc., 1996
 
Kay  SR;  Fiszbein  A;  Opler  LA:  The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.  Schizophrenia Bulletin 13:261–276, 1987
[CrossRef] | [PubMed]
 
Piersma  HL;  Boes  JL:  The GAF and psychiatric outcome: a descriptive report.  Community Mental Health Journal 33:35–41, 1997
[CrossRef] | [PubMed]
 
Kua  J;  Wong  KE;  Kua  EH  et al:  A 20-year follow-up study on schizophrenia in Singapore.  Acta Psychiatrica Scandinavica 108:118–125, 2003
[CrossRef] | [PubMed]
 
Ng  CH;  Chee Hong  Ng:  The stigma of mental illness in Asian cultures.  Australian and New Zealand Journal of Psychiatry 31:382–390, 1997
[CrossRef] | [PubMed]
 
Khan  TM;  Sulaiman  SA;  Hassali  MA  et al:  Community knowledge, attitudes, and beliefs towards depression in the state of Penang, Malaysia.  Community Mental Health Journal 46:87–92, 2010
[CrossRef] | [PubMed]
 
Dalgard  OS;  Mykletun  A;  Rognerud  M  et al:  Education, sense of mastery and mental health: results from a nationwide health monitoring study in Norway.  BMC Psychiatry 7:20–28, 2007
[CrossRef] | [PubMed]
 
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