A Prospective Analysis of Work in Schizophrenia

TLDR

The study investigates the longitudinal course of competitive employment in schizophrenia patients after acute exacerbation treatment and identifies sociodemographic and clinical predictors, suggesting that interventions should target education, cognition, and social competence to improve outcomes. A prospective cohort of 528 patients, with 313 followed up at 1 and 2 years, was assessed on demographics, premorbid functioning, work history, symptoms, social functioning, recent job‑search efforts, and interest, and analyses examined changes in employment and predictors of future work. Competitive employment rose from 10 % at baseline to 23 % and 21 % at 1‑ and 2‑year follow‑ups; interest and recent job‑search efforts predicted future work, and prior work experience, patient and mother’s education, cognitive impairment, and social functioning were key predictors of employment status.

Abstract

This study examined the longitudinal course of competitive employment in patients with schizophrenia following treatment for an acute exacerbation, and prospec-tively predicts work approximately 2 years later from sociodemographic and clinical characteristics. A sample of 528 patients was assessed at baseline, and 313 were followed up 1 and 2 years later. Assessments included sociodemographic characteristics, premorbid functioning, work history, symptoms, social functioning, recent efforts to find work, and interest in work. Analyses examined changes in competitive work from baseline to the followups, the correlates of work history, the prospective prediction of work at the 1- and 2-year followup assessments, and correlates of competitive work. Competitive employment increased significantly from 10 percent at baseline to 23 percent and 21 percent at the 1- and 2-year followups, respectively. At baseline, among patients who were not competitively working, 61 percent reported interest in working. Patients who were not competitively employed at baseline but reported making recent efforts to find work were more likely to be working at the followups than other not employed patients. Work at the 1- and 2-year followups was predicted by prior work experience, patient and mother's educational level, cognitive impairment, and social functioning. Similar correlates of current work status were found. Interventions may need to target educational level, cognitive impairment, and social competence and functioning in order to improve the competitive employment outcomes of persons with schizophrenia.