Pelizza Lorenzo, Leuci Emanuela, Quattrone Emanuela, Azzali Silvia, Pupo Simona, Paulillo Giuseppina, Pellegrini Pietro, Menchetti Marco
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Istituto di Psichiatria "Paolo Ottonello", viale Pepoli 5, 40123, Bologna, BO, Italy.
Department of Mental Health and Pathological Addictions, Azienda USL di Parma, largo Palli 1/a, 43100, Parma, PR, Italy.
Eur Child Adolesc Psychiatry. 2024 Jul;33(7):2217-2229. doi: 10.1007/s00787-023-02306-5. Epub 2023 Oct 9.
Service disengagement is a major concern for "Early Intervention in Psychosis" (EIP). Indeed, understanding predictors of engagement is important for the effectiveness of mental health interventions, to improve outcome and quality of life, also in adolescents with first episode psychosis (FEP). No specific European investigation on this topic in adolescence has been reported in the literature to date. The aim of this study was to investigate service disengagement rate and predictors in an Italian sample of FEP adolescents treated within an EIP program during a 2-year follow-up period. All participants were adolescents help-seekers (aged 12-18 years) enrolled in the "Parma Early Psychosis" (Pr-EP) program. At baseline, they completed the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Univariate and multivariate Cox regression analyses were performed. 71 FEP adolescents were recruited in this research. During the 2 years of our follow-up, a 25.4% prevalence rate of service disengagement was found. Particularly robust predictors of disengagement were lower baseline acceptance of psychosocial interventions, substance abuse at entry, and lower baseline PANSS "Disorganization" factor score. Approximately, 1/4 of our FEP adolescents disengaged from the Pr-EP program during the first 2 years of treatment. A possible solution to decrease disengagement and to favor re-engagement of these young individuals might be to provide the option of low-intensity monitoring and support, also via remote technology.
服务脱离是“精神病早期干预”（EIP）的一个主要问题。事实上，了解参与度的预测因素对于心理健康干预的有效性很重要，这有助于改善首发精神病（FEP）青少年的治疗结果和生活质量。迄今为止，文献中尚未报道过欧洲针对青少年这一主题的具体调查。本研究的目的是调查在一项EIP项目中接受治疗的FEP青少年意大利样本在2年随访期内的服务脱离率及预测因素。所有参与者均为参加“帕尔马早期精神病”（Pr-EP）项目的青少年求助者（年龄在12 - 18岁之间）。在基线时，他们完成了阳性和阴性症状量表（PANSS）以及功能总体评定量表（GAF）。进行了单变量和多变量Cox回归分析。本研究招募了71名FEP青少年。在我们为期2年的随访期间，发现服务脱离的患病率为25.4%。特别有力的脱离预测因素包括对心理社会干预的基线接受度较低、入组时存在物质滥用以及基线PANSS“紊乱”因子得分较低。在治疗的头2年里，我们大约1/4的FEP青少年脱离了Pr-EP项目。减少脱离并促进这些年轻人重新参与的一个可能解决方案可能是提供低强度监测和支持的选项，也可通过远程技术实现。
