title: Work functioning of schizophrenia patients in a rural south Indian community: status at 4-year follow-up.
abstract: OBJECTIVE
  This report describes the work functioning of schizophrenia patients receiving antipsychotic treatment in a rural south Indian community and examines the factors associated with it.
  
  
  METHODS
  We assessed work functioning of 201 patients who have completed a minimum of 3 years of follow-up as part of a cohort study of schizophrenia patients receiving community-based treatment. 'Work' section of the Indian disability evaluation and assessment scale (IDEAS) was used to evaluate work-related disability at the time of recruitment and after a mean (SD) 47.0 (9.6) months of follow-up. Patients with moderate to profound work-related disability were compared with those with no or mild disability across socio-demographic and clinical variables.
  
  
  RESULTS
  75 (37.3 %) were agriculturists; 58 (28.9 %) were pursuing household jobs; 28 (13.9 %) were daily wage labourers; 7 (3.5 %) were skilled labourers; 7 (3.5 %) were involved in other jobs. 26 (12.9 %) were not doing any sort of work. The proportion of patients with moderate or profound disability reduced from 137/201 (68.2 %) at baseline to 82/201 (40.8 %) at follow-up (p < 0.001). Work-related disability reduced significantly [mean (SD) work score on IDEAS was 2.2 (1.6) at baseline and 1.1 (1.2) at follow-up; t = -9.1; p < 0.001]. Logistic regression analysis showed that work-related disability was significantly associated with male gender, longer duration of illness, higher psychopathology and poor treatment adherence.
  
  
  CONCLUSIONS
  Nearly two-thirds of schizophrenia patients living in this rural south Indian community had satisfactory work functioning, a rate, which is substantially higher than rates reported from high-income countries. Agrarian work atmosphere and rural sociocultural milieu may have contributed to this in our sample. However, substantial proportion of patients remains considerably disabled. This highlights the need for concerted, community-level efforts to improve their functioning.
authors.affiliation: National Institute of Mental Health and Neurosciences (NIMHANS), 560029 Bangalore, India.
authors.forename: Kudumallige K
authors.initials: KK
authors.lastname: Suresh
authors.forename: Channaveerachari Naveen
authors.initials: CN
authors.lastname: Kumar
authors.forename: Jagadisha
authors.initials: J
authors.lastname: Thirthalli
authors.forename: Somashekar
authors.initials: S
authors.lastname: Bijjal
authors.forename: Basappa K
authors.initials: BK
authors.lastname: Venkatesh
authors.forename: Udupi
authors.initials: U
authors.lastname: Arunachala
authors.forename: Kengeri V
authors.initials: KV
authors.lastname: Kishorekumar
authors.forename: Doddaballapura K
authors.initials: DK
authors.lastname: Subbakrishna
authors.forename: Bangalore N
authors.initials: BN
authors.lastname: Gangadhar
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents