The association between community and service level factors and rates of disengagement in individuals with first episode psychosis.
Identifieur interne : 000684 ( Main/Exploration ); précédent : 000683; suivant : 000685The association between community and service level factors and rates of disengagement in individuals with first episode psychosis.
Auteurs : Siobhan Reynolds [Australie] ; Ellie Brown [Australie] ; Da Jung Kim [Australie] ; Hellen Geros [Australie] ; Holly Sizer [Australie] ; Scott Eaton [Australie] ; Rachel Tindall [Australie] ; Patrick Mcgorry [Australie] ; Brian O'Donoghue [Australie]Source :
- Schizophrenia research [ 1573-2509 ] ; 2019.
Descripteurs français
- KwdFr :
- Acceptation des soins par les patients (statistiques et données numériques), Adolescent (MeSH), Adulte (MeSH), Caractéristiques de l'habitat (statistiques et données numériques), Facteurs socioéconomiques (MeSH), Femelle (MeSH), Humains (MeSH), Intervention médicale précoce (statistiques et données numériques), Jeune adulte (MeSH), Mâle (MeSH), Schizophrénie (thérapie), Services de santé mentale (statistiques et données numériques), Troubles psychotiques (thérapie), Victoria (MeSH), Études de cohortes (MeSH).
- MESH :
- statistiques et données numériques : Acceptation des soins par les patients, Caractéristiques de l'habitat, Intervention médicale précoce, Services de santé mentale.
- thérapie : Schizophrénie, Troubles psychotiques.
- Adolescent, Adulte, Facteurs socioéconomiques, Femelle, Humains, Jeune adulte, Mâle, Victoria, Études de cohortes.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Cohort Studies (MeSH), Early Medical Intervention (statistics & numerical data), Female (MeSH), Humans (MeSH), Male (MeSH), Mental Health Services (statistics & numerical data), Patient Acceptance of Health Care (statistics & numerical data), Psychotic Disorders (therapy), Residence Characteristics (statistics & numerical data), Schizophrenia (therapy), Socioeconomic Factors (MeSH), Victoria (MeSH), Young Adult (MeSH).
- MESH :
- geographic : Victoria.
- statistics & numerical data : Early Medical Intervention, Mental Health Services, Patient Acceptance of Health Care, Residence Characteristics.
- therapy : Psychotic Disorders, Schizophrenia.
- Adolescent, Adult, Cohort Studies, Female, Humans, Male, Socioeconomic Factors, Young Adult.
Abstract
INTRODUCTION
Individuals who experience a first episode of psychosis require early intervention and regular follow-up in order to improve their prognosis and avoid long-term negative outcomes. However, approximately 30% of individuals accessing support will end up disengaging from early intervention (EI) services. Although we know that individual factors can impact rates of disengagement, less is known about potential service and community level factors.
METHODS
Data were gathered from a cohort of individuals attending a specialist youth mental health service in Melbourne, Australia between 1st January 2011 and 7th September 2014. Data were collected from clinical files and electronic medical records using a standardised audit instrument. Cox regression analysis was used to identify whether community level factors were predictors of disengagement.
RESULTS
Data were available for 707 young people experiencing a first episode of psychosis. Individuals residing in neighbourhoods of higher social deprivation were at a higher relative risk of disengaging, with 4.7% increase in engagement for each increase in decile of deprivation. The introduction of a new clinic was not significantly associated with a difference in the proportion of individuals disengaging from the service and distance to service was not significantly associated with disengagement rates.
DISCUSSION
Developing strategies focused on engaging young people with first episode psychosis who reside in more deprived areas may address the higher rates of disengagement these individuals experience. These finding suggest that location may not be a barrier to engagement, however services should be resourced in-line with the population demographic in their specific location.
DOI: 10.1016/j.schres.2019.05.037
PubMed: 31176534
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong 3220, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong 3220</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Kim, Da Jung" sort="Kim, Da Jung" uniqKey="Kim D" first="Da Jung" last="Kim">Da Jung Kim</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; 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Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Sizer, Holly" sort="Sizer, Holly" uniqKey="Sizer H" first="Holly" last="Sizer">Holly Sizer</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Eaton, Scott" sort="Eaton, Scott" uniqKey="Eaton S" first="Scott" last="Eaton">Scott Eaton</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Tindall, Rachel" sort="Tindall, Rachel" uniqKey="Tindall R" first="Rachel" last="Tindall">Rachel Tindall</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Mcgorry, Patrick" sort="Mcgorry, Patrick" uniqKey="Mcgorry P" first="Patrick" last="Mcgorry">Patrick Mcgorry</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="O Donoghue, Brian" sort="O Donoghue, Brian" uniqKey="O Donoghue B" first="Brian" last="O'Donoghue">Brian O'Donoghue</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052, Australia. Electronic address: brian.odonoghue@orygen.org.au.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2019">2019</date><idno type="RBID">pubmed:31176534</idno><idno type="pmid">31176534</idno><idno type="doi">10.1016/j.schres.2019.05.037</idno><idno type="wicri:Area/Main/Corpus">000853</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000853</idno><idno type="wicri:Area/Main/Curation">000853</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000853</idno><idno type="wicri:Area/Main/Exploration">000853</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The association between community and service level factors and rates of disengagement in individuals with first episode psychosis.</title><author><name sortKey="Reynolds, Siobhan" sort="Reynolds, Siobhan" uniqKey="Reynolds S" first="Siobhan" last="Reynolds">Siobhan Reynolds</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Brown, Ellie" sort="Brown, Ellie" uniqKey="Brown E" first="Ellie" last="Brown">Ellie Brown</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong 3220, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong 3220</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Kim, Da Jung" sort="Kim, Da Jung" uniqKey="Kim D" first="Da Jung" last="Kim">Da Jung Kim</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Geros, Hellen" sort="Geros, Hellen" uniqKey="Geros H" first="Hellen" last="Geros">Hellen Geros</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Sizer, Holly" sort="Sizer, Holly" uniqKey="Sizer H" first="Holly" last="Sizer">Holly Sizer</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Eaton, Scott" sort="Eaton, Scott" uniqKey="Eaton S" first="Scott" last="Eaton">Scott Eaton</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Tindall, Rachel" sort="Tindall, Rachel" uniqKey="Tindall R" first="Rachel" last="Tindall">Rachel Tindall</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Mcgorry, Patrick" sort="Mcgorry, Patrick" uniqKey="Mcgorry P" first="Patrick" last="Mcgorry">Patrick Mcgorry</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="O Donoghue, Brian" sort="O Donoghue, Brian" uniqKey="O Donoghue B" first="Brian" last="O'Donoghue">Brian O'Donoghue</name><affiliation wicri:level="4"><nlm:affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052, Australia. Electronic address: brian.odonoghue@orygen.org.au.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author></analytic><series><title level="j">Schizophrenia research</title><idno type="eISSN">1573-2509</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Cohort Studies (MeSH)</term><term>Early Medical Intervention (statistics & numerical data)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Mental Health Services (statistics & numerical data)</term><term>Patient Acceptance of Health Care (statistics & numerical data)</term><term>Psychotic Disorders (therapy)</term><term>Residence Characteristics (statistics & numerical data)</term><term>Schizophrenia (therapy)</term><term>Socioeconomic Factors (MeSH)</term><term>Victoria (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par les patients (statistiques et données numériques)</term><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Caractéristiques de l'habitat (statistiques et données numériques)</term><term>Facteurs socioéconomiques (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>Schizophrénie (thérapie)</term><term>Services de santé mentale (statistiques et données numériques)</term><term>Troubles psychotiques (thérapie)</term><term>Victoria (MeSH)</term><term>Études de cohortes (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Victoria</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Early Medical Intervention</term><term>Mental Health Services</term><term>Patient Acceptance of Health Care</term><term>Residence Characteristics</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Acceptation des soins par les patients</term><term>Caractéristiques de l'habitat</term><term>Intervention médicale précoce</term><term>Services de santé mentale</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Psychotic Disorders</term><term>Schizophrenia</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Schizophrénie</term><term>Troubles psychotiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Socioeconomic Factors</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Facteurs socioéconomiques</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Victoria</term><term>Études de cohortes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>Individuals who experience a first episode of psychosis require early intervention and regular follow-up in order to improve their prognosis and avoid long-term negative outcomes. However, approximately 30% of individuals accessing support will end up disengaging from early intervention (EI) services. Although we know that individual factors can impact rates of disengagement, less is known about potential service and community level factors.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Data were gathered from a cohort of individuals attending a specialist youth mental health service in Melbourne, Australia between 1st January 2011 and 7th September 2014. Data were collected from clinical files and electronic medical records using a standardised audit instrument. Cox regression analysis was used to identify whether community level factors were predictors of disengagement.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Data were available for 707 young people experiencing a first episode of psychosis. Individuals residing in neighbourhoods of higher social deprivation were at a higher relative risk of disengaging, with 4.7% increase in engagement for each increase in decile of deprivation. The introduction of a new clinic was not significantly associated with a difference in the proportion of individuals disengaging from the service and distance to service was not significantly associated with disengagement rates.</p></div><div type="abstract" xml:lang="en"><p><b>DISCUSSION</b></p><p>Developing strategies focused on engaging young people with first episode psychosis who reside in more deprived areas may address the higher rates of disengagement these individuals experience. These finding suggest that location may not be a barrier to engagement, however services should be resourced in-line with the population demographic in their specific location.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31176534</PMID><DateCompleted><Year>2020</Year><Month>09</Month><Day>28</Day></DateCompleted><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-2509</ISSN><JournalIssue CitedMedium="Internet"><Volume>210</Volume><PubDate><Year>2019</Year><Month>08</Month></PubDate></JournalIssue><Title>Schizophrenia research</Title><ISOAbbreviation>Schizophr Res</ISOAbbreviation></Journal><ArticleTitle>The association between community and service level factors and rates of disengagement in individuals with first episode psychosis.</ArticleTitle><Pagination><MedlinePgn>122-127</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0920-9964(19)30214-2</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.schres.2019.05.037</ELocationID><Abstract><AbstractText Label="INTRODUCTION">Individuals who experience a first episode of psychosis require early intervention and regular follow-up in order to improve their prognosis and avoid long-term negative outcomes. However, approximately 30% of individuals accessing support will end up disengaging from early intervention (EI) services. Although we know that individual factors can impact rates of disengagement, less is known about potential service and community level factors.</AbstractText><AbstractText Label="METHODS">Data were gathered from a cohort of individuals attending a specialist youth mental health service in Melbourne, Australia between 1st January 2011 and 7th September 2014. Data were collected from clinical files and electronic medical records using a standardised audit instrument. Cox regression analysis was used to identify whether community level factors were predictors of disengagement.</AbstractText><AbstractText Label="RESULTS">Data were available for 707 young people experiencing a first episode of psychosis. Individuals residing in neighbourhoods of higher social deprivation were at a higher relative risk of disengaging, with 4.7% increase in engagement for each increase in decile of deprivation. The introduction of a new clinic was not significantly associated with a difference in the proportion of individuals disengaging from the service and distance to service was not significantly associated with disengagement rates.</AbstractText><AbstractText Label="DISCUSSION">Developing strategies focused on engaging young people with first episode psychosis who reside in more deprived areas may address the higher rates of disengagement these individuals experience. These finding suggest that location may not be a barrier to engagement, however services should be resourced in-line with the population demographic in their specific location.</AbstractText><CopyrightInformation>Copyright © 2019 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><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, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>Ellie</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong 3220, Australia.</Affiliation></AffiliationInfo></Author><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, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Geros</LastName><ForeName>Hellen</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sizer</LastName><ForeName>Holly</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eaton</LastName><ForeName>Scott</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tindall</LastName><ForeName>Rachel</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McGorry</LastName><ForeName>Patrick</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>O'Donoghue</LastName><ForeName>Brian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia; Orygen Youth Health, 35 Poplar Road, Parkville, Victoria 3052, Australia. Electronic address: brian.odonoghue@orygen.org.au.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>06</Month><Day>05</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Schizophr Res</MedlineTA><NlmUniqueID>8804207</NlmUniqueID><ISSNLinking>0920-9964</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061345" MajorTopicYN="N">Early Medical Intervention</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008605" MajorTopicYN="N">Mental Health Services</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010342" MajorTopicYN="N">Patient Acceptance of Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="N">Psychotic Disorders</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012111" MajorTopicYN="N">Residence Characteristics</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012559" MajorTopicYN="N">Schizophrenia</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012959" MajorTopicYN="Y">Socioeconomic Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014739" MajorTopicYN="N" Type="Geographic">Victoria</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Disengagement</Keyword><Keyword MajorTopicYN="Y">First-episode psychosis</Keyword><Keyword MajorTopicYN="Y">Psychosis</Keyword><Keyword MajorTopicYN="Y">Psychotic disorders</Keyword><Keyword MajorTopicYN="Y">Schizophrenia</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year><Month>01</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2019</Year><Month>05</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>05</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>6</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>6</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31176534</ArticleId><ArticleId IdType="pii">S0920-9964(19)30214-2</ArticleId><ArticleId IdType="doi">10.1016/j.schres.2019.05.037</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li></country><region><li>Victoria (État)</li></region><settlement><li>Melbourne</li></settlement><orgName><li>Université de Melbourne</li></orgName></list><tree><country name="Australie"><region name="Victoria (État)"><name sortKey="Reynolds, Siobhan" sort="Reynolds, Siobhan" uniqKey="Reynolds S" first="Siobhan" last="Reynolds">Siobhan Reynolds</name></region><name sortKey="Brown, Ellie" sort="Brown, Ellie" uniqKey="Brown E" first="Ellie" last="Brown">Ellie Brown</name><name sortKey="Eaton, Scott" sort="Eaton, Scott" uniqKey="Eaton S" first="Scott" last="Eaton">Scott Eaton</name><name sortKey="Geros, Hellen" sort="Geros, Hellen" uniqKey="Geros H" first="Hellen" last="Geros">Hellen Geros</name><name sortKey="Kim, Da Jung" sort="Kim, Da Jung" uniqKey="Kim D" first="Da Jung" last="Kim">Da Jung Kim</name><name sortKey="Mcgorry, Patrick" sort="Mcgorry, Patrick" uniqKey="Mcgorry P" first="Patrick" last="Mcgorry">Patrick Mcgorry</name><name sortKey="O Donoghue, Brian" sort="O Donoghue, Brian" uniqKey="O Donoghue B" first="Brian" last="O'Donoghue">Brian O'Donoghue</name><name sortKey="Sizer, Holly" sort="Sizer, Holly" uniqKey="Sizer H" first="Holly" last="Sizer">Holly Sizer</name><name sortKey="Tindall, Rachel" sort="Tindall, Rachel" uniqKey="Tindall R" first="Rachel" last="Tindall">Rachel Tindall</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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