Engaging Immigrants in Early Psychosis Treatment: A Clinical Challenge.

OBJECTIVE: The study compared engagement in treatment and medication adherence of immigrants and nonimmigrants in early intervention services for persons with first-episode psychosis. METHODS: This two-year longitudinal prospective cohort study recruited patients with first-episode psychosis who were entering early intervention services in Montreal, Canada (N=223). Data on sociodemographic characteristics, symptoms, and social functioning were collected annually. RESULTS: At two years, immigrants had more than three times the odds of attrition than nonimmigrants after the analysis controlled for potential confounding factors (first-generation immigrants: odds ratio [OR]=3.11, 95% confidence interval [CI]=1.01-9.57, p=.049); second-generation immigrants: OR=3.65, CI=1.07-12.50, p=.039). Medication adherence was similar among those who remained in the programs. CONCLUSIONS: During the two years after entering a program for first-episode psychosis, immigrants were more likely than nonimmigrants to disengage from treatment. Further research is warranted to understand this phenomenon and to improve the ability of services to engage immigrants with first-episode psychosis.