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

Jack Cotter, Ashleigh Lin, Richard J. Drake, Andrew Thompson, Barnaby Nelson, Patrick D. McGorry, Stephen J. Wood, Alison R. Yung

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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.

Original languageEnglish
Pages (from-to)26-31
Number of pages6
JournalSchizophrenia Research
Volume184
DOIs
Publication statusPublished - 1 Jun 2017

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Psychotic Disorders
Unemployment
Wounds and Injuries
Substance-Related Disorders
Multivariate Analysis
Anxiety
Logistic Models
Regression Analysis
Education

Cite this

Cotter, J., Lin, A., Drake, R. J., Thompson, A., Nelson, B., McGorry, P. D., ... Yung, A. R. (2017). Long-term employment among people at ultra-high risk for psychosis. Schizophrenia Research, 184, 26-31. https://doi.org/10.1016/j.schres.2016.11.033
Cotter, Jack ; Lin, Ashleigh ; Drake, Richard J. ; Thompson, Andrew ; Nelson, Barnaby ; McGorry, Patrick D. ; Wood, Stephen J. ; Yung, Alison R. / Long-term employment among people at ultra-high risk for psychosis. In: Schizophrenia Research. 2017 ; Vol. 184. pp. 26-31.
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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.",
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Cotter, J, Lin, A, Drake, RJ, Thompson, A, Nelson, B, McGorry, PD, Wood, SJ & Yung, AR 2017, 'Long-term employment among people at ultra-high risk for psychosis' Schizophrenia Research, vol. 184, pp. 26-31. https://doi.org/10.1016/j.schres.2016.11.033

Long-term employment among people at ultra-high risk for psychosis. / Cotter, Jack; Lin, Ashleigh; Drake, Richard J.; Thompson, Andrew; Nelson, Barnaby; McGorry, Patrick D.; Wood, Stephen J.; Yung, Alison R.

In: Schizophrenia Research, Vol. 184, 01.06.2017, p. 26-31.

Research output: Contribution to journalArticle

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T1 - Long-term employment among people at ultra-high risk for psychosis

AU - Cotter, Jack

AU - Lin, Ashleigh

AU - Drake, Richard J.

AU - Thompson, Andrew

AU - Nelson, Barnaby

AU - McGorry, Patrick D.

AU - Wood, Stephen J.

AU - Yung, Alison R.

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N2 - 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.

AB - 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.

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KW - Functioning

KW - Psychosis

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