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Social Psychiatry and Psychiatric Epidemiology

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23.10.2019 | Original Paper

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

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

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 5/2020

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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.

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Titel: Predictors of study drop-out and service disengagement in patients at clinical high risk for psychosis
verfasst von: Letizia Leanza
Erich Studerus
Amatya J. Mackintosh
Katharina Beck
Leonie Seiler
Christina Andreou
Anita Riecher-Rössler
Publikationsdatum: 23.10.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 5/2020
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-019-01796-6

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