title: Rate and predictors of service disengagement among patients with first-episode psychosis.
abstract: OBJECTIVE
  This study determined the rate of service disengagement among patients in the Early Psychosis Intervention Program (EPIP) in Singapore and predictors of disengagement.
  
  
  METHODS
  EPIP is a two-year multidisciplinary program targeting first-episode psychosis. The sample comprised patients consecutively accepted (2001-2009) who had two years of follow-up data. Disengagement was assessed with a semistructured scale. Sociodemographic and clinical variables were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders, the Positive and Negative Syndrome Scale, and the Global Assessment of Functioning. Regression analyses were conducted.
  
  
  RESULTS
  Among 775 patients, 109 (14%) disengaged from EPIP within two years. Significant baseline predictors included Malay ethnicity (odds ratio [OR]=1.93, 95% confidence interval [CI]=1.12-3.29) and less than six years of education (OR=2.30, CI=1.23-4.29).
  
  
  CONCLUSIONS
  EPIP's engagement strategy should focus on patients of Malay ethnicity and of low educational attainment. Further studies should examine how these factors affect service disengagement.
authors.affiliation: National Psychiatry Residency Program, NHG-AHPL Residency, Ren Ci Community Hospital, Singapore. shushan.zheng@mohh.com.sg
authors.forename: Shushan
authors.initials: S
authors.lastname: Zheng
authors.forename: Lye Yin
authors.initials: LY
authors.lastname: Poon
authors.forename: Swapna
authors.initials: S
authors.lastname: Verma
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000628:therapy*; D045808:Refusal to Participate / Q000208:ethnology / Q000706:statistics & numerical data; D012846:Singapore; D013997:Time Factors; D055815:Young Adult