Ten-year employment patterns of patients with first-episode schizophrenia-spectrum disorders: comparison of early intervention and standard care services

Pang, Herbert; Yan, Kang K.; Hui, Christy Lai Ming; Suen, Yi Nam; Chang, Wing Chung; H, Lee; Sham, Pak C.; Chen, Eric

doi:10.1192/bjp.2019.161

Cited by 10 publications

(13 citation statements)

References 33 publications

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“…A previous study of general patients with schizophrenia also reported that being male is an independent positive predictor of employment 16. On the other hand, a recent study of patients with first-episode schizophrenia-spectrum disorders reported that females who receive standard care services have better employment outcomes than men 18. There was no sex difference in employment in the present study.…”

Section: Discussioncontrasting

confidence: 45%

“…The employment rate among patients with schizophrenia is also lower than that of the general population,1,5,9–12 ranging from 4% to 50.4%,13 with most studies reporting a rate between 10–20% 11,14. The severity of negative symptoms,15,16 cognitive dysfunction,17 early onset age and duration of illness,15 higher rate of early relapse,18 older age,16,17 and lower education,16 have all been reported to be negatively associated with employment outcomes 13,19. Work history is positively associated with employment rate 14.…”

Section: Introductionmentioning

confidence: 99%

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<p>Employment-Related Factors of Forensic Psychiatric Outpatients with Psychotic Disorders</p>

Takeda¹,

Sugawara²,

Yamada³

et al. 2019

NDT

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PurposeEmployment is important for forensic psychiatric patients with psychotic disorders, in terms of reduction in symptoms, improving the quality of life, and preventing re-offenses. However, few detailed studies on employment status in such patients exist. We aimed to determine the employment rate among forensic psychiatric outpatients with psychotic disorders and identify the factors associated with employment.Patients and methodsThe study population comprised 406 patients with psychotic disorders who completed a forensic outpatient treatment order, were aged <65 years at discharge from a forensic psychiatric ward and provided written informed consent. Psychotic disorders were defined as psychiatric disorders classified into F2 in the International Statistical Classification of Diseases and Related Health Problems, 10th edition. Demographic data were collected from the medical records of the inpatient treatment period. Prognostic data during the outpatient treatment order period was provided by the reintegration coordinators responsible for coordinating the patients’ social environment during this period. Exploratory univariate and multivariable logistic regression analyses identified the factors associated with employment.ResultsThe mean age at discharge was 44.4±10.8 years. The mean follow-up period was 2.69±1.01 years. There were 4.6 times more men (n=334) than women (n=72). During the outpatient treatment order period, 56 of 406 participants achieved employment (13.8%). Participants who committed serious crime, including homicide, arson, robbery, and sexual assault, had a lower employment rate compared to participants who committed bodily injury crimes (multivariable odds ratio, 0.421; 95% confidence interval, 0.220–0.807). History of substance use and living with family after discharge from a forensic psychiatric ward positively contributed to employment.ConclusionThe employment rate among forensic psychiatric outpatients with psychotic disorders was low and was similar to that reported in previous studies on general psychiatric patients with schizophrenia. Furthermore, serious criminal behavior negatively impacted employment.

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Section: Discussioncontrasting

confidence: 45%

Section: Introductionmentioning

confidence: 99%

<p>Employment-Related Factors of Forensic Psychiatric Outpatients with Psychotic Disorders</p>

Takeda¹,

Sugawara²,

Yamada³

et al. 2019

NDT

View full text Add to dashboard Cite

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“…A recent study found that 71% of the patients with schizophrenia living in the community were unemployed [63]. The number of relapses during the first three years and low level of education are predictors for unemployment among patients suffering from first-episode schizophrenia-spectrum disorders [64]. Apart from public stigma, patients often have self-stigma which lowers their self-esteem.…”

Section: Stigma Related To Psychiatric Illnesses and Advancement Of Amentioning

confidence: 99%

Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies

Zhang

Sun

Jatchavala

et al. 2019

IJERPH

157

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Background: In psychiatry, stigma is an attitude of disapproval towards people with mental illnesses. Psychiatric disorders are common in Asia but some Asians receive inadequate treatment. Previous review found that Asians with mental illness were perceived to be dangerous and aggressive. There is a need for renewed efforts to understand stigma and strategies which can effectively reduce stigma in specific Asian societies. The objective of this systematic review was to provide an up-to-date overview of existing research and status on stigma experienced by psychiatric patients and anti-stigma campaigns in China, Hong Kong, Japan, Singapore, Korea, and Thailand. Methods: A systematic literature search was conducted in the following databases, including PubMed, PsycINFO, Embase, Web of Science, and local databases. Studies published in English and the official language of included countries/territories were considered for inclusion in the systematic review. Any article on stigma related to any form of psychiatric illness in the six Asian societies was included. Results: One hundred and twenty-three articles were included for this systematic review. This review has six major findings. Firstly, Asians with mental illnesses were considered as dangerous and aggressive, especially patients suffering from schizophrenia and bipolar disorder; second, psychiatric illnesses in Asian societies were less socially-acceptable and were viewed as being personal weaknesses; third, stigma experienced by family members was pervasive and this is known as family stigma; fourth, this systemic review reported more initiatives to handle stigma in Asian societies than a decade ago; fifth, there have been initiatives to treat psychiatric patients in the community; and sixth, the role of supernatural and religious approaches to psychiatric illness was not prevailing. Conclusion: This systematic review provides an overview of the available scientific evidence that points to areas of needed intervention to reduce and ultimately eliminate inequities in mental health in Asia.

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“…Relapses have a significant impact on the outcomes of patients. Studies have shown that early relapses are associated with increasing suicide mortality (Chan et al, 2018) and poor long-term trajectories of employment (Chan et al, 2020). About one in six patients was found to exhibit protracted impairment after relapse (Emsley et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

The predictive power of expressed emotion and its components in relapse of schizophrenia: a meta-analysis and meta-regression

et al. 2021

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Background Schizophrenia is a longstanding condition and most patients experience multiple relapse in the course of the condition. High expressed emotion (HEE) has been found to be a predictor of relapse. This meta-analysis and meta-regression examined the association of global EE and relapse specifically focusing on timing of relapse and EE domains. Methods Random-effects model was used to pool the effect estimates. Multiple random-effects meta-regression was used to compute the moderator analysis. Putative effect moderators including culture, EE measurements, age, length of condition and study quality were included. Results Thirty-three prospective cohort studies comprising 2284 patients were included in the descriptive review and 30 studies were included for meta-analysis and meta-regression. Findings revealed that global HEE significantly predicted more on early relapse (⩽12 months) [OR 4.87 (95% CI 3.22–7.36)] than that on late relapse (>12 months) [OR 2.13 (95% CI 1.36–3.35)]. Higher level of critical comments (CC) significantly predicted relapse [OR 2.22 (95% CI 1.16–4.26)], whereas higher level of warmth significantly protected patients from relapse [OR 0.35 (95% CI 0.15–0.85)]. None of the moderators included significantly change the results. Conclusions These findings indicate that there is a dynamic interaction between EE-relapse association with time, and CC and warmth are the two important EE domains to influence relapse among patients with schizophrenia. Results also confirmed the foci of family interventions on reducing CC and improving warmth in relationship.

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Ten-year employment patterns of patients with first-episode schizophrenia-spectrum disorders: comparison of early intervention and standard care services

Cited by 10 publications

References 33 publications

<p>Employment-Related Factors of Forensic Psychiatric Outpatients with Psychotic Disorders</p>

<p>Employment-Related Factors of Forensic Psychiatric Outpatients with Psychotic Disorders</p>

Overview of Stigma against Psychiatric Illnesses and Advancements of Anti-Stigma Activities in Six Asian Societies

The predictive power of expressed emotion and its components in relapse of schizophrenia: a meta-analysis and meta-regression

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