Employment status amongst those with psychosis at first presentation.
BACKGROUND
Employment is generally beneficial to health and quality of life. Despite many advances in the treatment of psychosis there are continuing reports of high levels of unemployment. In most studies of first episode psychosis (FEP) only rudimentary rates of employment are provided. We sought to establish the prevalence of employment amongst those with FEP from a geographically defined area, to compare employment categories for differences in demographical and clinical characteristics and finally, to examine factors associated with employment.


METHODS
All cases of FEP were assessed from a defined suburban area with a structured clinical interview for DSM-III-R diagnosis and a standardised assessment protocol. Employment status was divided into employed, non-labour force work and unemployed.


RESULTS
Of 162 cases of psychosis, those employed (46%) were indistinguishable from those in non-labour force work (21%). Those unemployed (33%) had significantly longer DUP, more negative symptoms and lower quality of life than those engaged in non-labour force work or those employed. Having a non-affective psychosis (chi(2) = 0.05, OR = 1.2; 95% CI 1.0, 1.4) was associated with being unemployed at presentation. Better (beta = -0.2, P = 0.00) academic premorbid adjustment was associated with being employed at presentation.


CONCLUSIONS
Although 67% of those with FEP from a geographically defined area are engaged in purposeful work, the rate of unemployment is nine times the local rate. Longer DUP and negative symptoms are associated with unemployment at presentation. Standardised reporting of employment status would greatly assist research in this area.
Turner
Niall
N
Detect Early Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Ave., Blackrock, Co. Dublin, Ireland.
Browne
Stephen
S
Clarke
Mary
M
Gervin
Maurice
M
Larkin
Conall
C
Waddington
John L
JL
O'Callaghan
Eadbhard
E
D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011788:Quality of Life; D012917:Social Adjustment; D014478:Unemployment / Q000706:statistics & numerical data