Rate and Predictors of Service Disengagement in an Epidemiological First-Episode Psychosis Cohort

Conus, Philippe; Lambert, Martin; Cotton, Sue; Bonsack, Charles; McGorry, Patrick D.; Schimmelmann, Benno G.

doi:10.1016/j.schres.2010.02.480

Cited by 46 publications

(120 citation statements)

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“…Some have found an association whereas others have not (Conus et al, 2010;Macbeth et al, 2013). A potential limitation in this study was that as the CPN decided which patients were suitable for inclusion, patients with more severe symptoms may have been excluded.…”

Section: Discussionmentioning

confidence: 94%

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Predictors of engagement in first-episode psychosis

Casey

Brown

Gajwani

et al. 2016

Schizophrenia Research

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Engagement with psychiatric services is critical for ensuring successful outcomes in patients experiencing a first episode of psychosis (FEP). However, it is not known how sociodemographic factors and patient beliefs about the causes of mental illness affect engagement. This study explored predictors of engagement in a cohort of 103 FEP patients presenting to an early-intervention service. Beliefs that mental illness is caused by social stress or thinking odd thoughts predicted higher engagement scores. Patients with no qualifications were found to have higher engagement scores than those educated to a higher level. Ethnicity, gender, age and socioeconomic factors were not significantly correlated with engagement scores. Duration of untreated illness (DUI) significantly predicted higher engagement scores, but only for values greater than 1220 days. Duration of Untreated Psychosis (DUP) was not a significant predictor of patient engagement scores. Patient beliefs about the causes of mental illness are an important factor to be taken into consideration and may represent a target of interventions to increase engagement in FEP.

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Section: Discussionmentioning

confidence: 94%

“…Whilst some have found an association between duration of untreated psychosis (DUP) and engagement (Conus et al, 2010), others have not (Macbeth et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Predictors of engagement in first-episode psychosis

Casey

Brown

Gajwani

et al. 2016

Schizophrenia Research

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“…Of the functioning variables found in the eleven high-quality studies, employment seems to communicate the clearest findings: that it has little utility in predicting attendance. Although unemployment predicted less attendance in one study (Conus et al, 2010), six others found it to be non-significant. Further, psychiatric history variables at large were not often associated with attendance, although some of these variables were examined just once.…”

Section: Correlates Of Attendancementioning

confidence: 81%

“…The two studies which assessed two different outcomes were both rated as high quality, for a total of 13 separate high quality outcomes. Of high-quality studies, four examined time engaged (Conus et al, 2010;Schimmelman, Conus, Schacht, McGorry, & Lambert, 2006;Stowkowy et al, 2012;Ucok et al, 2007), six examined attendance (categorical) (Adelufosi, Ogunwale, Adeponle, & Abayomi, 2013;Adeponle, Thombs, Adelekan, & Kirmayer, 2009;Carrion, Swann, Keller-Cecil, & Barber, 1993;Sparr, Moffitt, & Ward, 1993;Stowkowy et al, 2012;Svettini et al, 1998), and three examined dropout (Kurtz, Rose, & Wexler, 2011;Turner, Smith-Hamel, & Mulder, 2007;Ucok et al, 2007).…”

Section: How Is Attendance Defined?mentioning

confidence: 99%

“…Three studies (Conus et al, 2010;Schimmelman et al, 2006;Stowkowy et al, 2012) found a significant (or trending) association between psychotic disorder not otherwise specified (as compared to schizophrenia) and poor attendance. A fourth study (Adeponle et al, 2009) found substance use diagnoses to be associated with poor attendance; this is consistent with the finding that continued substance use during treatment leads to poorer attendance (Conus et al, 2010;Schimmelman et al, 2006;Stowkowy et al, 2012;Turner et al, 2007), which was supported by all four studies investigating this variable. Other more varied results also emerged, indicating mood disorder diagnoses may be associated with better attendance (Turner et al, 2007), as may be schizophrenia (Svettini et al, 1998) and diagnoses other than PTSD (Sparr et al, 1993).…”

Section: Correlates Of Attendancementioning

confidence: 99%

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Correlates of attendance in mental health services for individuals with psychotic disorders: A critical review

Bonfils

Bouchard

Kukla

et al. 2016

American Journal of Psychiatric Rehabilitation

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Purpose: Low attendance to mental health care results in loss of time, money, and treatment gains. No prior review in this area has taken into account the quality of studies or varying definitions of attendance.The current review provides a critical evaluation of variables associated with attendance in consumers with psychotic symptoms participating in outpatient mental health services, with a focus on study quality and operationalization of attendance. Methods: EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched for empirical articles relevant to attendance to mental health services by individuals diagnosed with a psychotic disorder. Eligible articles were rated for quality by two coauthors; high-quality articles were reviewed in-depth. Results: Twenty-eight articles were eligible; eleven articles qualified for in-depth review. Four attendance outcome types were identified, including the prediction of dropout, time engaged, categorical attendance, and continuous attendance. Ongoing substance use during treatment was consistently associated with lower attendance in high-quality articles.Conclusions: More high quality research using systematically defined outcome types is needed to identify reliable associations with attendance. Commonly tested variables such as demographics show little utility in predicting attendance. Future research in this area should expand upon current findings focusing on clinically and theoretically relevant variables.

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