PoplarV1, Main, Exploration, bibRecord, 000671

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

Identifieur interne : 000671 ( Main/Exploration ); précédent : 000670; suivant : 000672

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

Auteurs : Da Jung Kim [Australie] ; Ellie Brown [Australie] ; Siobhan Reynolds [Australie] ; Hellen Geros [Australie] ; Holly Sizer [Australie] ; Rachel Tindall [Australie] ; Patrick Mcgorry [Australie] ; Brian O'Donoghue [Australie]

Source :

Social psychiatry and psychiatric epidemiology [ 1433-9285 ] ; 2019.

RBID : pubmed:30923838

Descripteurs français

KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Australie (MeSH), Femelle (MeSH), Humains (MeSH), Intervention médicale précoce (statistiques et données numériques), Jeune adulte (MeSH), Mâle (MeSH), Participation des patients (statistiques et données numériques), Résultat thérapeutique (MeSH), Troubles psychotiques (psychologie), Troubles psychotiques (thérapie), Études rétrospectives (MeSH).
MESH :
- psychologie : Troubles psychotiques.
- statistiques et données numériques : Intervention médicale précoce, Participation des patients.
- thérapie : Troubles psychotiques.
- Adolescent, Adulte, Australie, Femelle, Humains, Jeune adulte, Mâle, Résultat thérapeutique, Études rétrospectives.
Wicri :
- geographic : Australie.

English descriptors

KwdEn :
- Adolescent (MeSH), Adult (MeSH), Australia (MeSH), Early Medical Intervention (statistics & numerical data), Female (MeSH), Humans (MeSH), Male (MeSH), Patient Participation (statistics & numerical data), Psychotic Disorders (psychology), Psychotic Disorders (therapy), Retrospective Studies (MeSH), Treatment Outcome (MeSH), Young Adult (MeSH).
MESH :
- geographic : Australia.
- psychology : Psychotic Disorders.
- statistics & numerical data : Early Medical Intervention, Patient Participation.
- therapy : Psychotic Disorders.
- Adolescent, Adult, Female, Humans, Male, Retrospective Studies, Treatment Outcome, Young Adult.

Abstract

BACKGROUND

A core component of treatment provided by early intervention for psychosis (EI) services is ensuring individuals remain successfully engaged with the service. This ensures they can receive the care they may need at this critical early stage of illness. Unfortunately, rates of disengagement are high in individuals with a first episode of psychosis (FEP), representing a major barrier to effective treatment. This study aimed to ascertain the rates and determinants of disengagement and subsequent re-engagement of young people with FEP in a well-established EI service in Melbourne, Australia.

METHOD

This cohort study involved all young people, aged 15-24, who presented to the Early Psychosis Prevention and Intervention Centre (EPPIC) service with FEP between 1st January 2011 and 1st September 2014. Data were collected retrospectively from clinical files and electronic records. Cox regression analysis was used to identify determinants of disengagement and re-engagement.

RESULTS

A total of 707 young people presented with FEP during the study period, of which complete data were available for 700. Over half of the cohort (56.3%, N = 394) disengaged at least once during their treatment period, however, the majority of these individuals (85.5%, N = 337) subsequently re-engaged following the initial episode of disengagement. Of those who disengaged from the service, 54 never re-engaged, representing 7.6% of the total cohort. Not being in employment, education or training, not having a family history of psychosis in second degree relatives and using cannabis were found to be significant predictors of disengagement. No significant predictors of re-engagement were identified.

CONCLUSION

In this study, the rate of disengagement in young people with first-episode psychosis was higher than found previously. Encouragingly, rates of re-engagement were also high. The concept of disengagement from services might be more complex than previously thought with individuals disengaging and re-engaging a number of times during their episode of care. What prompts individuals to re-engage with services needs to be better understood.

DOI: 10.1007/s00127-019-01698-7
PubMed: 30923838

Affiliations:

Links toward previous steps (curation, corpus...)

to stream Main, to step Corpus: 000966
to stream Main, to step Curation: 000966

Le document en format XML

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<author><name sortKey="Kim, Da Jung" sort="Kim, Da Jung" uniqKey="Kim D" first="Da Jung" last="Kim">Da Jung Kim</name>
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<orgName type="university">Université de Melbourne</orgName>
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<region type="état">Victoria (État)</region>
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<affiliation wicri:level="1"><nlm:affiliation>Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, 3220, Australia.</nlm:affiliation>
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<author><name sortKey="Reynolds, Siobhan" sort="Reynolds, Siobhan" uniqKey="Reynolds S" first="Siobhan" last="Reynolds">Siobhan Reynolds</name>
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<country xml:lang="fr">Australie</country>
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<country xml:lang="fr">Australie</country>
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<orgName type="university">Université de Melbourne</orgName>
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<author><name sortKey="Geros, Hellen" sort="Geros, Hellen" uniqKey="Geros H" first="Hellen" last="Geros">Hellen Geros</name>
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<country xml:lang="fr">Australie</country>
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<author><name sortKey="Sizer, Holly" sort="Sizer, Holly" uniqKey="Sizer H" first="Holly" last="Sizer">Holly Sizer</name>
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<author><name sortKey="Tindall, Rachel" sort="Tindall, Rachel" uniqKey="Tindall R" first="Rachel" last="Tindall">Rachel Tindall</name>
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<orgName type="university">Université de Melbourne</orgName>
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<author><name sortKey="Mcgorry, Patrick" sort="Mcgorry, Patrick" uniqKey="Mcgorry P" first="Patrick" last="Mcgorry">Patrick Mcgorry</name>
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<author><name sortKey="O Donoghue, Brian" sort="O Donoghue, Brian" uniqKey="O Donoghue B" first="Brian" last="O'Donoghue">Brian O'Donoghue</name>
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<wicri:noRegion>3052</wicri:noRegion>
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<affiliation wicri:level="4"><nlm:affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia. brian.odonoghue@orygen.org.au.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052</wicri:regionArea>
<orgName type="university">Université de Melbourne</orgName>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Orygen Youth Health, 35 Poplar Road, Parkville, VIC, 3052, Australia. brian.odonoghue@orygen.org.au.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
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</affiliation>
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<series><title level="j">Social psychiatry and psychiatric epidemiology</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term>
<term>Adult (MeSH)</term>
<term>Australia (MeSH)</term>
<term>Early Medical Intervention (statistics & numerical data)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Patient Participation (statistics & numerical data)</term>
<term>Psychotic Disorders (psychology)</term>
<term>Psychotic Disorders (therapy)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term>
<term>Adulte (MeSH)</term>
<term>Australie (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Intervention médicale précoce (statistiques et données numériques)</term>
<term>Jeune adulte (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Participation des patients (statistiques et données numériques)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Troubles psychotiques (psychologie)</term>
<term>Troubles psychotiques (thérapie)</term>
<term>Études rétrospectives (MeSH)</term>
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<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Troubles psychotiques</term>
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<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Psychotic Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Early Medical Intervention</term>
<term>Patient Participation</term>
</keywords>
<keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Intervention médicale précoce</term>
<term>Participation des patients</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Psychotic Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Troubles psychotiques</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Retrospective Studies</term>
<term>Treatment Outcome</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Australie</term>
<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Résultat thérapeutique</term>
<term>Études rétrospectives</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Australie</term>
</keywords>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>A core component of treatment provided by early intervention for psychosis (EI) services is ensuring individuals remain successfully engaged with the service. This ensures they can receive the care they may need at this critical early stage of illness. Unfortunately, rates of disengagement are high in individuals with a first episode of psychosis (FEP), representing a major barrier to effective treatment. This study aimed to ascertain the rates and determinants of disengagement and subsequent re-engagement of young people with FEP in a well-established EI service in Melbourne, Australia.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHOD</b>
</p>
<p>This cohort study involved all young people, aged 15-24, who presented to the Early Psychosis Prevention and Intervention Centre (EPPIC) service with FEP between 1st January 2011 and 1st September 2014. Data were collected retrospectively from clinical files and electronic records. Cox regression analysis was used to identify determinants of disengagement and re-engagement.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>A total of 707 young people presented with FEP during the study period, of which complete data were available for 700. Over half of the cohort (56.3%, N = 394) disengaged at least once during their treatment period, however, the majority of these individuals (85.5%, N = 337) subsequently re-engaged following the initial episode of disengagement. Of those who disengaged from the service, 54 never re-engaged, representing 7.6% of the total cohort. Not being in employment, education or training, not having a family history of psychosis in second degree relatives and using cannabis were found to be significant predictors of disengagement. No significant predictors of re-engagement were identified.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>In this study, the rate of disengagement in young people with first-episode psychosis was higher than found previously. Encouragingly, rates of re-engagement were also high. The concept of disengagement from services might be more complex than previously thought with individuals disengaging and re-engaging a number of times during their episode of care. What prompts individuals to re-engage with services needs to be better understood.</p>
</div>
</front>
</TEI>
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<DateCompleted><Year>2019</Year>
<Month>11</Month>
<Day>05</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>02</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1433-9285</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>54</Volume>
<Issue>8</Issue>
<PubDate><Year>2019</Year>
<Month>Aug</Month>
</PubDate>
</JournalIssue>
<Title>Social psychiatry and psychiatric epidemiology</Title>
<ISOAbbreviation>Soc Psychiatry Psychiatr Epidemiol</ISOAbbreviation>
</Journal>
<ArticleTitle>The rates and determinants of disengagement and subsequent re-engagement in young people with first-episode psychosis.</ArticleTitle>
<Pagination><MedlinePgn>945-953</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s00127-019-01698-7</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">A core component of treatment provided by early intervention for psychosis (EI) services is ensuring individuals remain successfully engaged with the service. This ensures they can receive the care they may need at this critical early stage of illness. Unfortunately, rates of disengagement are high in individuals with a first episode of psychosis (FEP), representing a major barrier to effective treatment. This study aimed to ascertain the rates and determinants of disengagement and subsequent re-engagement of young people with FEP in a well-established EI service in Melbourne, Australia.</AbstractText>
<AbstractText Label="METHOD" NlmCategory="METHODS">This cohort study involved all young people, aged 15-24, who presented to the Early Psychosis Prevention and Intervention Centre (EPPIC) service with FEP between 1st January 2011 and 1st September 2014. Data were collected retrospectively from clinical files and electronic records. Cox regression analysis was used to identify determinants of disengagement and re-engagement.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 707 young people presented with FEP during the study period, of which complete data were available for 700. Over half of the cohort (56.3%, N = 394) disengaged at least once during their treatment period, however, the majority of these individuals (85.5%, N = 337) subsequently re-engaged following the initial episode of disengagement. Of those who disengaged from the service, 54 never re-engaged, representing 7.6% of the total cohort. Not being in employment, education or training, not having a family history of psychosis in second degree relatives and using cannabis were found to be significant predictors of disengagement. No significant predictors of re-engagement were identified.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">In this study, the rate of disengagement in young people with first-episode psychosis was higher than found previously. Encouragingly, rates of re-engagement were also high. The concept of disengagement from services might be more complex than previously thought with individuals disengaging and re-engaging a number of times during their episode of care. What prompts individuals to re-engage with services needs to be better understood.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kim</LastName>
<ForeName>Da Jung</ForeName>
<Initials>DJ</Initials>
<AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
</AffiliationInfo>
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<ForeName>Ellie</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, 3220, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Reynolds</LastName>
<ForeName>Siobhan</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
</AffiliationInfo>
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<AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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<AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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<AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.</Affiliation>
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</AffiliationInfo>
<AffiliationInfo><Affiliation>Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia. brian.odonoghue@orygen.org.au.</Affiliation>
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<AffiliationInfo><Affiliation>Orygen Youth Health, 35 Poplar Road, Parkville, VIC, 3052, Australia. brian.odonoghue@orygen.org.au.</Affiliation>
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<Language>eng</Language>
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<ArticleDate DateType="Electronic"><Year>2019</Year>
<Month>03</Month>
<Day>28</Day>
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<MedlineTA>Soc Psychiatry Psychiatr Epidemiol</MedlineTA>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001315" MajorTopicYN="N" Type="Geographic">Australia</DescriptorName>
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<MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Disengagement</Keyword>
<Keyword MajorTopicYN="N">First-episode psychosis</Keyword>
<Keyword MajorTopicYN="N">Predictors</Keyword>
<Keyword MajorTopicYN="N">Psychotic disorders</Keyword>
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The rates and determinants of disengagement and subsequent re-engagement in young people with first-episode psychosis.

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

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