ArticleSchizophrenia bulletin open2022
Rates and Predictors of Disengagement and Strength of Engagement for People With a First Episode of Psychosis Using Early Intervention Services: A Systematic Review of Predictors and Meta-analysis of Disengagement Rates.
Article in Schizophrenia bulletin open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Early interventions for first onset of symptoms of mental health conditions: an umbrella review of systematic reviews.BMC medicine · 2026Pooled it
- Barriers and facilitators to engagement in psychological therapy in first episode psychosis: A meta-ethnography and qualitative comparative analysis.Psychology and psychotherapy · 2025Pooled it
- Engagement and Acceptability of Acceptance and Commitment Therapy in Daily Life in Early Psychosis: Secondary Findings From a Multicenter Randomized Controlled Trial.JMIR formative research · 2024Trial
- The Early Youth Engagement (EYE-2) Intervention in First Episode Psychosis Services: Definition and Implementation of a Therapeutic Motivational-Engagement Model for Early Intervention in Psychosis Key Workers.Early intervention in psychiatry · 2026Article
- Discharge From Coordinated Specialty Care: Timing, Reasons, and Predictors in a National Early Psychosis Network.Psychiatric services (Washington, D.C.) · 2026Article
- Religiosity and Engagement in Early Intervention Programme for First-Episode Psychosis.Early intervention in psychiatry · 2026Article
- Client Engagement With an Early Psychosis Program and Post-Program Health Service Use: A Retrospective Cohort Study.Early intervention in psychiatry · 2026Article
- The impact of symptoms and illness insight on treatment adherence in first-episode psychosis: a one-year follow-up study using therapeutic drug monitoring.BMC psychiatry · 2026Article
- Sex-specific clinical profiles and long-term outcomes in adolescents and young people at clinical high risk for psychosis: Findings from the PARMS program.European child & adolescent psychiatry · 2026Article
- Digital and Immersive Technologies for Rehabilitation in Complex Psychosis: State of the Art and Future Directions.Medicina (Kaunas, Lithuania) · 2026Review
- A Mixed Methods Study of Program-Level Factors Influencing Patient and Family Engagement in First Episode Psychosis Coordinated Specialty Care.medRxiv : the preprint server for health sciences · 2026Article
- Adaptation of a brief intervention to support engagement in early psychosis services: a service user-informed psychotherapy modification and study protocol.Frontiers in psychology · 2026Article
- What autism features in first episode psychosis? Results from a 2-year follow-up study.European archives of psychiatry and clinical neuroscience · 2025Article
- Predictors of Service Engagement and Disengagement in Community-Based Coordinated Specialty Care for Early Psychosis in Texas.Community mental health journal · 2025Article
- Sex comparisons on the beneficial effects of an early intervention program in a patients' cohort with first episode psychosis: what effectiveness in women?Archives of women's mental health · 2025Article
- Engagement, Disengagement and Re-Engagement in Mental Health Services Among Young Patients With First-Episode Psychosis: A Scoping Review.Early intervention in psychiatry · 2025Article
- Implementation of an Online Mental Health Website for the Early Intervention in Psychosis Services, Developed for the Early Youth Engagement (EYE-2) Trial: A Cross-Sectional Survey Study of Clinical Barriers and Facilitators to Normalisation.Early intervention in psychiatry · 2025Article
- Reasons for Discharge in a National Network of Early Psychosis Intervention Programs.Schizophrenia bulletin · 2025Article
- Qualitative Analysis of Telephone Logs: Client Engagement and Barriers to Completing an Initial Early Psychosis Assessment.Psychiatric services (Washington, D.C.) · 2025Article
- Baseline Exposure to Antipsychotic Medication in Young People at Clinical High Risk for Psychosis: A 2-Year Italian Follow-Up Study.Human psychopharmacology · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Disengagement is a problem in early intervention for psychosis services; identifying predictors is important to maximise mental-health care. Aim: To establish the average disengagement rate, time to disengage, and predictors of disengagement or strength of engagement. Methods: Papers were identified from 5 databases and citation searches; chosen if they reported dis/engagement in early intervention services, discarded if they didn't give a clear definition of disengagement. The studies were rated for quality and a systematic review identified predictors of engagement; meta-analysis established the average disengagement rate. Meta-regression evaluated associations between disengagement and year of study or length of follow up. Results: 26 papers were reviewed comprising over 6800 participants, meta-analysis of 15 eligible cohorts found that the average disengagement rate was 15.60% (95% confidence intervals 11.76%-20.45%), heterogeneity was considerable, important to note when reporting as a global average. Higher disengagement rates were associated with earlier studies and length of follow up; causal factors are unclear due to the lack of data and complex interaction between clinical and methodological issues. Robust predictors of disengagement were substance use, contact with the criminal justice system, medication non-adherence, and lower symptom severity. Conclusions: Disengagement rates have declined although the cause is not clear partly due to methodological variation, we suggest a guide for defining disengagement. Underpinning reasons for disengagement could include people who struggle to engage (substance users), don't want to engage (medication non-adherence) or feel they don't need to engage (lower symptomology). Future research should focus on minority status, education/employment during treatment, and digital technologies.
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