1. Objectifs

Intentions :
The «primary aim [of the study] was to investigate differences in patients’ and families’ service engagement in similarly structured first episode psychosis programs in Montreal, Canada and Chennai, India.» (p. 2) The «second aim was to explain inter-site difference in the rates of patient service disengagement.» (p. 2)

Questions/Hypothèses :
For the first aim of the study, the authors «hypothesized that fewer patients would drop out in Chennai.» (p. 2) They «also hypothesized that families would be engaged for more months in Chennai than in Montreal.» (p. 2) For the second aim, the authors «hypothesized that this difference would be mediated by family involvement, after accountingfor other established predictors of disengagement.» (p. 2)

2. Méthode

Échantillon/Matériau :
«This prospective study was conducted from 2012 to 2018 at two early intervention sites – one comprising two McGill University-affiliated services in Montreal, and the other being the first-episode psychosis program of the Schizophrenia Research Foundation (SCARF) in Chennai, India.» (p. 2) «The study included data about 333 patients with first-episode psychosis (165 in Montreal, 168 in Chennai) and their family members (156 in Montreal, 168 in Chennai).» (p. 3) Data were assessed by the staff of both sites.

Type de traitement des données :
Analyse statistique

3. Résumé

The authors «found that fewer patients with first-episode psychosis dropped out of treatment and more families were involved throughout the course of treatment in Chennai, India than in Montreal, Canada.» (p. 7) Also, «[e]ven in Montreal, every additional month of contact between families and the team reduced the risk of patients disengaging by 16%. There may be some bidirectionality in the relationship between patient and family engagement, with patient disengagement usually resulting in loss of contact with families, particularly in contexts like Montreal.» (p. 7) «In Montreal, the engagement of families varied widely and depended on the phase of treatment […]. The substantially less family contact relative to patient contact in Montreal […] is indicative of the individual patient being the fundamental unit of therapeutic attention to which the relationship with the family is secondary. This is also apparent in the observation that during months when the Montreal treating team did not have contact with families, the team perceived such contact as not necessary […].» (p. 8)