Background: To assess the risk and predictors of non-adherence with treatment (NAT) in adolescents with first episode psychosis (FEP) receiving their first treatment in a long-standing early intervention and prevention centre.
Methods: The Early Psychosis Prevention and Intervention Centre (EPPIC) in Australia admitted 157 adolescents with FEP from 1998 to 2000. Treatment at EPPIC spans an average of 18- months. Data were collected from patients medical records (MR) using a standardized questionnaire. 134 MR were available. Time to NAT was the outcome of interest. Baseline and treatment predictors of NAT were examined via cox proportional hazards model.
Results: Kaplan-Meier 18-month NAT-risk was 0.28. A lower severity of illness at baseline (HR=0.20), living without family during treatment (HR=4.8), and persistent substance use during treatment (HR=2.6) contributed significantly to predicting NAT. Neither initial substance use nor insight at baseline was related to NAT.
Conclusions: Clinicians should focus on treating substance use and establishing a social network if family support is missing in adolescents with FEP. Additionally, clinicians should apply strategies to keep in touch with those adolescents who might not agree upon the necessity of continuous treatment due to a moderate severity of illness.