ARTICLE DOWNLOAD

Predictors of study drop-out and service disengagement in patients at clinical high risk for psychosis

10.00$
ARTICLE DOWNLOAD

Predictors of study drop-out and service disengagement in patients at clinical high risk for psychosis

10.00$

Letizia Leanza, Erich Studerus, Amatya J. Mackintosh, Katharina Beck, Leonie Seiler, Christina Andreou & Anita Riecher-Rössler 

Abstract

Purpose

Study drop-out during follow-up and service disengagement frequently occur in patients at clinical high risk for psychosis (CHR-P). However, little is known about their predictors. Therefore, we aimed to analyze the rate and reasons for drop-out and service disengagement in CHR-P patients and investigate their sociodemographic and clinical predictors.

Methods

Data from 200 patients of the prospective Früherkennung von Psychosen (FePsy) study were analyzed with competing risks survival models, considering drop-out and transition to psychosis as competing events. To investigate whether symptoms changed immediately before drop-out, t tests were applied.

Results

Thirty-six percent of patients dropped out within 5 years. Almost all drop-outs also disengaged from our service. Hence, study drop-out was used as a proxy for service disengagement. Patients with more severe baseline disorganized symptoms and a late inclusion into the study were significantly more likely to disengage. Immediately before disengagement, there was significant improvement in negative symptoms only.

Conclusion

A considerable proportion of CHR-P patients disengaged from our clinical study and service. Patients who were included during a later study period with more assessments disengaged more often, which might have been due to more frequent invitations to follow-up assessments and thereby increasing participation burden. Hence, our study provides a cautionary note on high-frequency follow-up assessments. Larger-scale studies evaluating predictors on multiple domains would help to further elucidate drop-out and disengagement.

Only units of this product remain
Year 2020
Language English
Format PDF
DOI 10.1007/s00127-019-01796-6