Vocational intervention in first-episode psychosis: Individual placement and support <i>v.</i> treatment as usual

Killackey, Eóin; Jackson, Henry; McGorry, Patrick D.

doi:10.1192/bjp.bp.107.043109

Cited by 269 publications

(287 citation statements)

References 28 publications

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“…Such approaches have been shown to be effective for improving vocational outcome among young people experiencing a first-episode of psychosis (Killackey et al, 2008;Bond et al, 2015). Our findings in this UHR cohort suggest these recommendations should be extended to the UHR group.…”

Section: Discussionmentioning

confidence: 72%

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

Cotter

Lin

Drake

et al. 2017

Schizophrenia Research

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Word count abstract: 250Word count paper: 2,894 Number of tables: 2Supplementary data: Supplementary Table 1 2 Abstract BackgroundPsychotic disorders are associated with high rates of sustained unemployment, however, little is known about the long-term employment outcome of people at ultrahigh 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 UHR patients recruited from the Personal Assessment and Crisis Evaluationclinic 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. ResultsA 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.3 ConclusionsNearly a quarter of this UHR sample were 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.

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Section: Discussionmentioning

confidence: 72%

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

Cotter

Lin

Drake

et al. 2017

Schizophrenia Research

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“…Existing measures of functioning often have a strong emphasis on engagement in paid work (Killackey et al, 2008). Whilst work represents a key marker of social recovery, it is not the only marker of improvement.…”

Section: Measuring Social Functioningmentioning

confidence: 99%

Comparing time use in individuals at different stages of psychosis and a non-clinical comparison group

Hodgekins

French

Birchwood

et al. 2015

Schizophrenia Research

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Social functioning difficulties are a common and disabling feature of psychosis and have also been identified in the prodromal phase. However, debate exists about how such difficulties should be defined and measured. Time spent in structured activity has previously been linked to increased psychological wellbeing in non-clinical samples and may provide a useful way of assessing social functioning in clinical settings. All three clinical groups spent significantly fewer hours per week in structured activity than individuals in the non-clinical group. Reduced activity levels were observed before the onset of psychosis in individuals with at-risk mental states. Additional reductions in activity were observed in the first-episode psychosis and delayed recovery groups compared to the at-risk mental state group. Assessing time spent in structured activity provides a useful way to assess social disability and recovery across the spectrum of psychosis.

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“…Increasingly there has been attention to the fact that medications, while assisting in symptomatic recovery, do not, by themselves, contribute to a return to functioning. This has led to an increased focus on the need to enhance social recovery (68) especially educational and vocational aspects (83)(84)(85), through the combination of effective psychosocial interventions with well-managed medication. There is also an increasing focus on targeted cognitive remediation (86) to limit the degree of cognitive decline that is often found as illness progresses.…”

Section: Stage 2: Early Detection and Treatment Of First Episode Psycmentioning

confidence: 99%

Early intervention in psychosis: concepts, evidence and future directions

2008

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Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual

Abstract: Individual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.

Cited by 269 publications

References 28 publications

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

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

Comparing time use in individuals at different stages of psychosis and a non-clinical comparison group

Early intervention in psychosis: concepts, evidence and future directions

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