Context and contact: a comparison of patient and family engagement with early intervention services for psychosis in India and Canada

• DOI: 10.1017/s0033291720003359
• Publication Date: 2020-09-28T02:25:07Z
• Authors: Srividya N. Iyer; Ashok Malla; Aarati Taksal; Anika Maraj; Greeshma Mohan; Padmavati Ramacha...; Howard C. Margolese; Norbert Schmitz; Ridha Joober; Thara Rangaswamy
• Keywords: Disengagement theory

Abstract Background It is unknown whether patient disengagement from early intervention services for psychosis as prevalent in low- and middle-income countries (LMICs) like India, it high-income (HICs). Addressing this gap, we studied two first-episode programs Montreal, Canada Chennai, India. We hypothesized lower service among patients higher engagement families that family would mediate cross-site differences disengagement. Methods Sites were compared on their 2-year rates conducting time-to-event analyses independent samples t tests monthly contact data. Along with site involvement, Cox proportional hazards regression included known predictors of (e.g. gender). Results The study data about 333 (165 168 Chennai) members (156 Chennai). More Montreal (19%) disengaged before 24 months than Chennai (1%), χ 2 (1, N = 333) 28.87, p < 0.001. had more clinicians throughout treatment (Cohen's d −1.28). Family significantly predicted (HR 0.87, 95% CI 0.81–0.93). Unlike declined over time perceiving such not necessary 1.73). Conclusions This the first investigation across a HIC an LMIC. Patient was strikingly Chennai. Maintaining may benefit engagement, irrespective context. Findings also suggest differential utilization underpin cross-cultural variations outcomes.