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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
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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


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
Table Footer Note

a Tertiary, polytechnic or university education



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