Long-term employment among people at ultra-high risk for psychosis

Article English OPEN
Cotter, Jack ; Lin, Ashleigh ; Drake, Richard ; Thompson, Andrew ; Nelson, Barnaby ; McGorry, Patrick ; Wood, Stephen ; Yung, Alison (2016)

Background\ud \ud Psychotic disorders are associated with high rates of sustained unemployment, however, little is known about the long-term employment outcome of people at ultra-high risk (UHR) of developing psychosis. We sought to investigate the long-term unemployment rate and baseline predictors of employment status at follow-up in a large UHR cohort.\ud \ud Method\ud \ud 268 UHR patients recruited from the Personal Assessment and Crisis Evaluation clinic in Melbourne, Australia were followed-up over 2–14 years after initial presentation to the service. Individuals in no form of employment or education were classed as unemployed. Logistic regression analyses were used to examine predictors of employment outcome.\ud \ud Results\ud \ud A high rate of unemployment was present at follow-up in this UHR sample (23%). At baseline, those who were unemployed at follow-up had a longer duration of untreated illness, more severe negative symptoms, lower IQ, poorer social and occupational functioning and reported more childhood trauma than the employed group. At follow-up, unemployed individuals exhibited significantly more severe symptoms on all measures and were more likely to have been diagnosed with a mood, anxiety, psychotic or substance use disorder. Childhood trauma and the duration of untreated illness at baseline were significant independent predictors of employment status at follow-up in the multivariate analyses.\ud \ud Conclusions\ud \ud Nearly a quarter of this UHR sample was unemployed at long-term follow-up. The duration of untreated illness and the effects of childhood trauma are potentially modifiable risk factors for long-term employment outcome in this group. Vocational support may be beneficial for many UHR patients presenting to services.
  • References (29)
    29 references, page 1 of 3

    Aas, M., Dazzan, P., Mondelli, V., Melle, I., Murray, R.M., Pariante, C.M., 2014. A systematic review of cognitive function in first-episode psychosis, including a discussion on childhood trauma, stress, and inflammation. Front. Psychiatry 4, 182.

    Addington, J., Cornblatt, B.A., Cadenhead, K.S., Cannon, T.D., McGlashan, T.H., Perkins, D.O., Seidman, L.J., Tsuang, M.T., Walker, E.F., Woods, S.W., Heinssen, R., 2011. At clinical high risk for psychosis: outcome for nonconverters. Am. J.

    Psychiatry 168 (8), 800-805.

    Andreasen, N.C., 1984. Scale for the Assessment of Negative Symptoms. University of Iowa Press, Iowa City.

    Barbato, M., Liu, L., Penn, D.L., Keefe, R.S., Perkins, D.O., Woods, S.W., Addington, J., 2013. Social cognition as a mediator between neurocognition and functional outcome in individuals at clinical high risk for psychosis. Schizophr. Res.

    Barnes, T.R., Hutton, S.B., Chapman, M.J., Mutsatsa, S., Puri, B.K., Joyce, E.M., 2000. West London first-episode study of schizophrenia. Clinical correlates of duration of untreated psychosis. Br. J. Psychiatry 77, 207-211.

    Bernstein, D.P., Stein, J.A., Newcomb, M.D., Walker, E., Pogge, D., Ahluvalia, T., Stokes, J., Handelsman, L., Medrano, M., Desmond, D., Zule, W., 2003.

    Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 27 (2), 169-190.

    Knapp, M., Mangalore, R., Simon, J., 2004. The global costs of schizophrenia.

    Schizophr. Bull. 30 (2), 279-293.

  • Metrics
    No metrics available
Share - Bookmark