Incomes and Outcomes: Social Security Disability Benefits in First-Episode Psychosis

Rosenheck, Robert A.; Estroff, Sue E.; Sint, Kyaw; Lin, Haiqun; Mueser, Kim T.; Robinson, Delbert G.; Schooler, Nina R.; Marcy, Patricia; Kane, John M.

doi:10.1176/appi.ajp.2017.16111273

Cited by 33 publications

(15 citation statements)

References 36 publications

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“…This is in line with findings from other studies, and with the idea of IPS. Even if the literature also provides some indications of the contrary (Nygren, #1322), reviews of effectiveness studies do not indicate that vocational or educational outcomes in IPS are contingent on symptom levels, at least not alone (Heffernan & Pilkington, ) (Bond, Drake & Campbell, ; Rosenheck et al ). Other factors, driven by welfare policy and employment markets, are at least as important (Metcalfe, Drake, & Bond, ).…”

Section: Discussionmentioning

confidence: 99%

Job‐ and schoolprescription: A local adaptation to individual placement and support for first episode psychosis

Hegelstad

Joa

Heitmann

et al. 2018

Early Intervention Psych

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The School- and JobPrescription adaptation of IPS, allowing for temporary internships as a step towards obtaining the goal of paid competitive employment and facilitating flexible combinations of employment and education, showed encouraging results. These were however not sustained after closure of the intervention. At the 2-year follow up, Job- and SchoolPrescription advantages had waned, underscoring the point in IPS that support should be time-unlimited.

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Section: Discussionmentioning

confidence: 99%

Job‐ and schoolprescription: A local adaptation to individual placement and support for first episode psychosis

Hegelstad

Joa

Heitmann

et al. 2018

Early Intervention Psych

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“…Our outcomes are schizophrenia-related admissions over the entire 10-year model horizon (defined as hospitalizations per 1000 patientyears) (Olfson, Ascher-Svanum, Faries, & Marcus, 2011), competitive employment (Slade & Salkever, 2001), and independent or family living (Tsai, Stroup, & Rosenheck, 2011) at the end of the chronic phase, and receipt of disability benefits in the form of Social Supplemental Security Income or Social Security Disability Insurance at the start of the chronic phase (Rosenheck et al, 2017).…”

Section: Model Outcomesmentioning

confidence: 99%

Simulated long‐term outcomes of early use of long‐acting injectable antipsychotics in early schizophrenia

Horvitz-Lennon

Predmore

Orr

et al. 2018

Early Intervention Psych

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Aim Duration of untreated psychosis in early schizophrenia impacts long‐term outcomes. Because long‐acting injectable (LAI) antipsychotic drugs improve adherence in early‐stage patients, they could reduce additional time in uncontrolled psychosis (TUP) during the critical period of the illness. However, the long‐term benefit of early LAI use over oral formulations has not been quantified. This study explores the potential magnitude of the benefit with a simulation approach. Methods A microsimulation models the effects of 11 treatment pathways reflecting alternative decisions on whether and when LAI agents are used during a “calibration phase” that starts at treatment entry and lasts until the end of the 3‐year critical period. Treatment failure prolongs time in psychosis. Long‐term outcomes are predicted over the ensuing 7‐year period as a function of TUP. Results An “early LAI” pathway where LAI treatment follows the second oral treatment failure is compared to an oral‐only pathway. Under these pathways, 69% and 46% of patients, respectively, are estimated to exit the calibration phase with adequate symptom control (total positive and negative syndrome scale score below 68). Relative to the oral‐only pathway, the early LAI pathway is predicted to increase competitive employment by 39% (25% vs 18%) and independent or family living by 22% (71% vs 58%), and to decrease receipt of disability benefits by 36% (42% vs 66%) and hospital admissions per 1000 patient‐years by 15% (249% vs 294%). Conclusions While these simulation results need to be confirmed empirically, they suggest that earlier use of LAI antipsychotics can meaningfully improve patient outcomes.

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“…Schizophrenia features amongst the leading causes of disability worldwide 1 because it is associated with chronicity, 2,3 psychosocial disadvantage 4,5 and reduced life expectancy 6,7 . The five years following the first psychotic episode are considered a critical period as the long-term pattern of the disease course is typically established during this time 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Baseline brain structural and functional predictors of clinical outcome in the early course of schizophrenia

et al. 2018

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Although schizophrenia is considered a brain disorder, the role of brain organization for symptomatic improvement remains inadequately defined. We investigated the relationship between baseline brain morphology, resting-state network connectivity and clinical response after 24-weeks of antipsychotic treatment in patients with schizophrenia (n=95) using integrated multivariate analyses. There was no significant association between clinical response and measures of cortical thickness (r=0.37, p=0.98) and subcortical volume (r=0.56, p=0.15). By contrast, we identified a strong mode of covariation linking functional network connectivity to clinical response (r=0.70; p=0.04), and particularly to improvement in positive (weight=0.62) and anxious/depressive symptoms (weight=0.49). Higher internal cohesiveness of the default mode network was the single most important positive predictor. Key negative predictors involved the functional cohesiveness of central executive subnetworks anchored in the frontoparietal cortices and subcortical regions (including the thalamus and striatum) and the inter-network integration between the default mode and sensorimotor networks. The present findings establish links between clinical response and the functional organization of brain networks involved both in perception and in spontaneous and goal-directed cognition, thereby advancing our understanding of the pathophysiology of schizophrenia.

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Incomes and Outcomes: Social Security Disability Benefits in First-Episode Psychosis

Cited by 33 publications

References 36 publications

Job‐ and schoolprescription: A local adaptation to individual placement and support for first episode psychosis

Job‐ and schoolprescription: A local adaptation to individual placement and support for first episode psychosis

Simulated long‐term outcomes of early use of long‐acting injectable antipsychotics in early schizophrenia

Baseline brain structural and functional predictors of clinical outcome in the early course of schizophrenia

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