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Title: Readmission in psychosis and in CBTp : associations with patient education level and belief flexibility status
Author: Soremekun, Mishael
Awarding Body: University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2012
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Background and objectives Previous studies have shown that Cognitive Behavioural Therapy for psychosis (CBTp) does not reduce readmission rates. This could be due to particular patient characteristics. This study sought to assess whether patients' education level and belief flexibility status were associated with readmission following CBTp treatment. The association between other psycho-social factors and readmission was also explored. Method Using the South London and Maudsely NHS Trust case register, 3025 adult patients with an F20-F29 ICD-1O diagnosis, discharged from inpatient care to the community during 2008-2009 were identified. They were categorised on the basis of their level of education, belief flexibility status and other psycho-social variables and followed-up until December 2011 , to ascertain their time to readmission. Results Cox proportional regression analyses showed that those with a G.C.S.E. level education were significantly less likely to readmit when compared with those with no qualifications. A trend for lower readmission was also observed in the A' level and above group. There was no evidence of an association between belief flexibility and readmission in patients who had CBTp treatment (N=469). A trend for a lower rate of readmission was observed for those with a G.C.S.E. level education in the CBTp sample. Other psycho-social factors were strongly associated with readmission for all patients. Conclusion These findings suggest that some psycho-social factors are important for readmission in psychosis, but not belief flexibility. Structural changes to mental health service provision in the UK are indicated to tackle this client group who experience high levels of social adversity. Modifications to CaTp provision to increase access to a full course ofCBTp are also needed. Future studies with larger CaTp samples that explore the relationship between belief flexibility and readmission and the impact of structural-level interventions could help further our understanding in this area.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available