Measures and Predictors of Community-Based Employment and Earnings of Persons With Schizophrenia in a Multisite Study

Salkever, David S.; Karakuş, Mustafa; Slade, Eric P.; Harding, Courtenay M.; Hough, Richard L.; Rosenheck, Robert A.; Swartz, Marvin S.; Barrio, Concepción; Yamada, Ann-Marie

doi:10.1176/ps.2007.58.3.315

Cited by 108 publications

(26 citation statements)

References 31 publications

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“…It is well known that patients with schizophrenia have increased risk of low socioeconomic status, possibly due to the impairments of social functioning caused by the disease, 40 in accordance with the present data. That higher income is associated with decreased future risk of hospitalization with schizophrenia in our study is likely caused by generally reduced income for participants prior to hospitalization with schizophrenia rather than higher income being protective against schizophrenia.…”

Section: Discussionsupporting

confidence: 93%

Elevated C-Reactive Protein Associated With Late- and Very-Late-Onset Schizophrenia in the General Population: A Prospective Study

Wium‐Andersen¹,

Ørsted²,

Nordestgaard³

2013

Schizophrenia Bulletin

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Background: Individuals with autoimmune diseases and severe infections have persistent or acutely elevated inflammatory biomarkers and increased risk of schizophrenia. We tested the hypothesis that baseline elevated plasma levels of the inflammatory biomarker, C-reactive protein (CRP), associate with increased risk of late-and very-lateonset schizophrenia in the general population, and if such an association possibly is causal. Method: We analyzed data from 78 810 men and women, aged 20-100 years, from 2 large population studies. Endpoints were hospitalization with schizophrenia and schizophrenia and schizophrenialike psychosis combined. We performed prospective and cross-sectional analyses adjusted for potential confounders with up to 20 years of follow-up. Furthermore, we used genetic variants influencing plasma CRP levels to perform a Mendelian randomization study. Results: Age-and gender-adjusted hazard ratios vs individuals in the first quartile of CRP were 1.7 (95% CI: 0.3-8.9) for second quartile, 2.1 (0.4-10) for third quartile, and 11 (2.8-40) for fourth quartile individuals. The corresponding hazard ratio for fourth quartile individuals after multifactorial adjustment was 5.9 (1.4-24). Furthermore, individuals with vs without schizophrenia had 63% increased plasma levels of CRP (P = 1 × 10 −4 ). Finally, when CRP was on a continuous scale, a doubling in CRP yielded an age-and gender-adjusted observational OR of 1.5 (1.3-1.8) and a corresponding causal OR of 1.4 (0.5-4.3) (observed vs causal: P = .89). Conclusion: Baseline elevated plasma CRP is associated with a 6-to 11-fold increased risk of late-and very-late-onset schizophrenia in the general population. We cannot exclude that this is a causal association. These are novel findings.

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Section: Discussionsupporting

confidence: 93%

Elevated C-Reactive Protein Associated With Late- and Very-Late-Onset Schizophrenia in the General Population: A Prospective Study

Wium‐Andersen¹,

Ørsted²,

Nordestgaard³

2013

Schizophrenia Bulletin

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“…In fact, the literature indicates that employment rates for people with schizophrenia are much lower than in the general population, ranging between 14.5-17.2% in the United States (USA) [2,3] and 11.5% in France, 12.9% in the United Kingdom (UK) and 30.3% in Germany [4], placing people with schizophrenia among those disability groups that are highly likely to be unemployed [5]. These findings mean that the schizophrenia has a considerable economic burden on families and health systems; they also suggest that people with schizophrenia do not enjoy the multiple benefits of paid employment, which are widely documented.…”

Section: Introductionmentioning

confidence: 99%

Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials

Carmona

Gómez-Benito

Huedo‐Medina

et al. 2017

Int J Occup Med Environ Health

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Access to employment plays a critical role in the recovery and functioning of people with schizophrenia. We have investigated the effectiveness of treatments to enhance employment outcomes for people with schizophrenia and evaluated the potential moderators of these outcomes. A literature search was conducted in CINAHL, Cochrane Databases, MED-LINE, ProQuest XML, PsycINFO, Scopus, and Web of Science. Grey literature databases, references lists of the retrieved articles and specialized journals in the field were also inspected. Job placement, job tenure and wages earned were tested. Risk ratios were extracted for job placement and standardized mean differences were calculated for job tenure and wages earned. Twenty-five randomized controlled trials published between 1986 and December 2015 were analyzed. Engaging in a vocational intervention increases the likelihood of obtaining a competitive job (risk ratio (RR) = 2.31, 95% confidence interval (CI): 1.85-2.88) and has a positive impact on hours worked in any job (standardized mean difference (SMD) = 0.42, 95% CI: 0.16-0.68). There was no evidence of intervention efficacy with regard to wages earned from competitive employment. Participation in rehabilitative vocational treatment is not sufficient to ensure work participation for people with schizophrenia. Comprehensive treatments are necessary to address functional deficits that hinder labor stability and job performance for people with schizophrenia. Int J Occup Med Environ Health 2017;30(3):345-366

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“…Unemployment rates for clinical samples of patients with schizophrenia range usually from 60 to 90% [1,2]. The ability to work is markedly impaired in individuals with schizophrenia, especially in developed countries where jobs are, on average, more complicated than in less advanced societies [3].…”

Section: Introductionmentioning

confidence: 99%

Cognitive function and competitive employment in schizophrenia: relative contribution of insight and psychopathology

Giugiario

Crivelli

Mingrone

et al. 2011

Soc Psychiatry Psychiatr Epidemiol

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Taken together, these findings confirmed the importance of cognitive function in obtaining competitive employment. Our results also highlighted the independent role of general psychopathology and awareness of illness on occupational functioning in schizophrenia. Thus, a greater attention must be given to the systematic investigation of insight and general psychopathology in light of an amelioration of vocational functioning in stable schizophrenia.

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Measures and Predictors of Community-Based Employment and Earnings of Persons With Schizophrenia in a Multisite Study

Abstract: Work attachment and earnings were substantially lower than in previous survey data, not very sensitive to labor market conditions, and strongly related to clinical status.

Cited by 108 publications

References 31 publications

Elevated C-Reactive Protein Associated With Late- and Very-Late-Onset Schizophrenia in the General Population: A Prospective Study

Elevated C-Reactive Protein Associated With Late- and Very-Late-Onset Schizophrenia in the General Population: A Prospective Study

Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials

Cognitive function and competitive employment in schizophrenia: relative contribution of insight and psychopathology

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