The rates and determinants of disengagement and subsequent re-engagement in young people with first-episode psychosis

Engagement with online psychosocial interventions for psychosis: A review and synthesis of relevant factors

“…Personal motivation and agency were required to achieve progress and continue with CBT. CBT considered effortful due to concentration on specific cognitive processes; Barriers to engagement also include readiness for therapy Kim et al (2019) Australia FEP 700 EIS (Service) disengagement, re-engagement Active refusal of contact or untraceable, making face-to-face contact with clinical staff following disengagement Disengagement associated with: not being in employment/education/training; not having a second-degree relative with psychosis; concurrent substance abuse (cannabis & amphetamine) Age (when controlling for confounding variables), gender, family history of psychosis, diagnosis (affective v non-affective) and DUP. No variables associated with re-engaging following disengagement Kukla et al (2014) USA Sz spectrum 50 CBTp Engagement (engagers v. non-engagers) Attending >7 sessions Engagers had a higher educational attainment than non-engagers.…”

“…Substance and alcohol use are common amongst individuals with psychotic disorders ( Koskinen et al, 2009a , Koskinen et al, 2009b ; Sara et al, 2014 ). In face-to-face therapies, alcohol, cannabis and other substance use have been associated with disengagement from early psychosis programs ( Conus et al, 2010 ; Kim et al, 2019 ; Miller et al, 2009 ; Schimmelmann et al, 2006 ; Turner et al, 2007 ). Other investigations found no association between early psychosis service engagement and alcohol or substance use ( Anderson et al, 2013 ; Fanning et al, 2012 ; Lecomte et al, 2008 ; Spidel et al, 2015 ; Stowkowy et al, 2012 ).…”

“…Regarding traditional psychosocial services, the majority of identified studies found no association between age and engagement ( Alvarez-Jimenez et al, 2009 ; Johansen et al, 2011 ; Kim et al, 2019 ; Kukla et al, 2014 ; Lecomte et al, 2008 ; Lincoln et al, 2014 ; Ma et al, 2012 ; Miller et al, 2009 ; Schimmelmann et al, 2006 ; Thomas et al, 2018 ; Turner et al, 2007 ). However, older age has been associated with higher rates of dropout and disengagement from psychosocial treatments for schizophrenia and early psychosis ( Anderson et al, 2013 ; Villeneuve et al, 2010 ).…”

“…While females are typically more help-seeking than males, findings between gender and engagement with psychosocial treatments for psychosis have been mixed ( Thompson et al, 2016 ). Many studies found gender was not associated with service engagement ( Alvarez-Jimenez et al, 2009 ; Anderson et al, 2013 ; Casey et al, 2016 ; Conus et al, 2010 ; Gurak et al, 2017 ; Kim et al, 2019 ; Kukla et al, 2014 ; Lincoln et al, 2014 ; Ma et al, 2012 ; Schimmelmann et al, 2006 ; Thomas et al, 2018 ; Turner et al, 2007 ). However, male gender was associated with increased risk of dropout in meta-analytic examination ( Villeneuve et al, 2010 ), and lower rates of engagement amongst individuals with both early psychosis and schizophrenia ( Lecomte et al, 2008 ; Tsang et al, 2010 ).…”

Incidence of catastrophic healthcare expenditure and its main determinants in Mexican households caring for a person with a mental disorder

“…In this respect, even though it has been reported that health insurance coverage protects against expenditures that are considered catastrophic (Tirgil et al ., 2019), it is not sufficient: according to the present results and other reports in the literature, protection rather depends on the social context of the health system and other tangible barriers to access (Kisely et al ., 2009; Gal et al ., 2017; Erlangga et al ., 2019; Kim et al ., 2019; Ta et al ., 2020). In this sense, strategies for healthcare for MD is centered on the capacitation of human resources, in strengthening the health system, as well as in the direct provision of medical attention to mental health (Hanlon et al ., 2018), with the understanding that expenses for hospitalization and medicine are principal causes of CHE, as demonstrated in the present study sample.…”