Department of Biomedical and Neuromotor Sciences, "Alma Mater Studiorum", Università di Bologna, Viale Pepoli, 5, 40126, Bologna, BO, Italy.
Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.
Soc Psychiatry Psychiatr Epidemiol. 2024 Jul;59(7):1201-1213. doi: 10.1007/s00127-023-02564-3. Epub 2023 Oct 13.
Service disengagement is a major concern for "Early Intervention in Psychosis" (EIP). Indeed, identifying predictors of engagement is crucial to maximize mental healthcare interventions in first-episode psychosis (FEP). No Italian study on this topic has been reported to date. Thus, the aims of this investigation were: (1) to examine short-term disengagement rate in an Italian population of FEP patients treated within an EIP service across a 1-year follow-up period, and (b) to assess the most relevant predictors of disengagement in the first year of treatment.
All participants were young FEP help-seeking patients, aged 12-35 years, enrolled within the "Parma Early Psychosis" (Pr-EP) protocol. At baseline, they completed the Positive And Negative Syndrome Scale (PANSS), the Health of the Nation Outcome Scale (HoNOS) and the Global Assessment of Functioning (GAF) scale. Univariate and multivariate Cox regression analyses were used.
496 FEP individuals were enrolled in this research. Across the follow-up, a 16.5% prevalence of short-term disengagement was found. Particularly robust predictors of service disengagement were poor baseline treatment non-adherence, living with parents and the presence of brief psychotic disorder or schizophreniform disorder at entry.
About 16% of FEP patients disengaged the Pr-EP program within the first year of treatment. A solution to reduce disengagement and/or to favor re-engagement of these subjects might be to remain on EIP program caseloads allowing the option for low-intensity support and monitoring, also via remote technology.
服务脱节是“精神病早期干预”（EIP）的主要关注点。事实上，确定参与的预测因素对于最大限度地提高首发精神病（FEP）的精神保健干预措施至关重要。迄今为止，尚未有关于该主题的意大利研究报告。因此，本研究的目的是：（1）在为期 1 年的随访期间，检查意大利 EIP 服务中治疗的 FEP 患者的短期脱组率，（b）评估治疗第一年脱组的最相关预测因素。
所有参与者均为寻求帮助的年轻 FEP 患者，年龄在 12-35 岁之间，均参加了“帕尔马早期精神病”（Pr-EP）方案。在基线时，他们完成了阳性和阴性综合征量表（PANSS），国家卫生结果量表（HoNOS）和总体功能评估（GAF）量表。使用单变量和多变量 Cox 回归分析。
这项研究共纳入了 496 名 FEP 个体。在随访过程中，发现短期脱组率为 16.5%。治疗不依从、与父母同住以及入院时存在短暂精神病性障碍或精神分裂样障碍是服务脱节的强有力预测因素。
大约 16%的 FEP 患者在治疗的第一年就脱离了 Pr-EP 计划。减少脱组和/或有利于重新融入这些患者的解决方案可能是保留在 EIP 计划病例量中，允许通过远程技术提供低强度的支持和监测。
