Employment and income among first-time cases diagnosed with non-affective psychosis in Stockholm, Sweden: a follow-up study 2004/2005-2010.
OBJECTIVE
Non-affective psychoses (F20-F29) are serious conditions causing a high degree of disability. Loss of income and increasing costs for personal care and treatment are severe consequences following the disorders, but less is known about employment and income in different social strata. The aim was to study these conditions among persons with non-affective psychosis compared to the general population, and possible social differentials.


METHODS
A population-based follow-up study with 530,350 persons (aged 18-44), including 756 first-time cases diagnosed with non-affective psychosis registered in in- or outpatient psychiatric care in 2005 or 2006. Age-standardised rates of non-employment, disability pension, social assistance and poverty were calculated at baseline and at follow-up in 2010. Odds ratios of poverty were estimated using logistic regression, adjusting for employment status, age, education and country of birth.


RESULTS
Before diagnosis, rates of non-employment, disability pension and social assistance were higher among persons with non-affective psychosis compared to the general population. At the follow-up, rates of disability pension had doubled, most pronounced among women with only compulsory education. Rates of social assistance were twice as high for foreign-born women. Among persons with non-affective psychosis, non-employment, lower education (among men) and being foreign born (among women) were associated with an increased risk of poverty at follow-up.


CONCLUSIONS
Poor employment and income conditions were found among persons with non-affective psychosis, but the social insurance system seemed to alleviate the poor income conditions. Early and preventative support to encourage employment and income security is needed, which could support recovery.
Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden. johanna.falk@ki.se.
Johanna
J
Falk
Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden.
Bo
B
Burström
Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden.
Christina
C
Dalman
Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden.
Lena
L
Jörgensen
Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden.
Daniel
D
Bruce
Department of Public Health Sciences (PHS), Karolinska Institutet, Stockholm, Sweden.|Centre for Epidemiology and Community Medicine (CES), Stockholm County Council, Stockholm, Sweden.
Lotta
L
Nylén
D000293:Adolescent; D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010415:Pensions / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis*; D012946:Social Welfare / Q000706:statistics & numerical data; D013548:Sweden; D055815:Young Adult
County; Employment; Non-affective psychosis; Poverty; Social differentials; Stockholm