Cotter, Jack, Lin, Ashleigh, Drake, Richard J., Thompson, Andrew David, Nelson, Barnaby, McGorry, Patrick, Wood, Stephen J. and Yung, Alison R. (2017) Long-term employment among people at ultra-high risk for psychosis. Schizophrenia Research, 184 . pp. 26-31. doi:10.1016/j.schres.2016.11.033

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Abstract

Background

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.

Method

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.

Results

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.

Conclusions

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.

Item Type:	Journal Article
Subjects:	H Social Sciences > HD Industries. Land use. Labor R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Unemployment, Unemployed, Affective disorders, Melbourne (Vic.), Psychoses, Psychoses in children, Anxiety disorders, Substance abuse, Australia
Journal or Publication Title:	Schizophrenia Research
Publisher:	Elsevier BV
ISSN:	0920-9964
Official Date:	June 2017
Dates:	Date Event June 2017 Published 27 November 2016 Available 22 November 2016 Accepted 24 June 2016 Submitted
Volume:	184
Page Range:	pp. 26-31
DOI:	10.1016/j.schres.2016.11.033
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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