Background: A study conducted in 2000 revealed that 50% of patients did not attend outpatient appointment after a first admission for psychosis. In the frame of the development of the Lausanne TIPP program in 2004, patients were assessed at baseline presentation and during 3 years follow-up. The aims of the study were: (1) to explore patients profile in order to adapt treatment program and (2) to assess impact of the program on treatment disengagement.
Methods: Assessment of demographic and clinical characteristics through a specially designed questionnaire used at entry to the service by case managers and comparison of disengagement rate before and after program implementation.
Results: A sample of 89 patients was assessed between April 2004 and June 2006. Evaluation of pre-morbid characteristics revealed high rates of substance use disorder (SUD) (45%), history of psychiatric disorder (68.5%), traumatic events (71.6%), suicide attempts (16.9%) and family history of psychiatric illness (71.6%). At baseline, there was high rate of lack of insight (85%). Median duration of untreated psychosis (DUP) was 6 months. While 50% of patients failed to attend first outpatient appointment before program implementation, all patients enrolled in the program were seen after discharge from hospital and rate of disengagement after 12 months was 15%.
Conclusions: Patients' profile is similar to that of other first episode psychosis cohorts. Implementation of the program has had an important impact on transition with outpatient care. Disengagement rates are relatively low compared to other studies.