Service engagement in first episode psychosis: clinical and premorbid correlates

Angus MacBeth, Andrew Gumley, Matthias Schwannauer, Rebecca Fisher

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)


Engagement can be understood as a multi-factorial process incorporating acceptance of treatment, therapeutic rapport and collaboration in a shared goal of clinical and functional recovery. Difficulties in engagement with clinical services represent a risk factor for treatment discontinuation in First Episode Psychosis. The current study explored associations between engagement, clinical and pre-onset variables.

We report cross sectional data on a Scottish First Episode Psychosis sample,
characterised in terms of psychotic symptomatology, premorbid adjustment,
Duration of untreated psychosis and clinician rated engagement.

Poorer clinician rated engagement was associated with greater positive and negative symptoms, greater general psychopathology and poorer premorbid social adjustment. In a regression analysis only severity of negative symptoms predicted engagement.

The study highlights the role of negative symptoms and impairments in social
functioning as factors associated with poorer engagement with clinical services. The value of detailed assessment of social and premorbid functioning is highlighted.
Original languageEnglish
Pages (from-to)359-364
Number of pages6
JournalThe Journal of Nervous and Mental Disease
Issue number5
Publication statusPublished - May 2013


  • schizophrenia
  • psychosis
  • engagement
  • quality of care
  • premorbid adjustment


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