Predictors of vocational status in schizophrenia patients – Results from the Polish nationwide survey

Abstract

Background:Steady employment constitutes one of most important aspects of functional recovery in schizophrenia. Therefore, there is a need for understanding clinical and demographic factors predicting vocational status in schizophrenia.Methods:Clinical and demographic data of 1,010 schizophrenia patients were gathered from public outpatient clinics. We compared patients who maintained employment between the diagnosis time point and the day of assessment, with the patients who were employed in the diagnosis time point but were unemployed on the day of assessment with respect to clinical and demographic variables.Results:Lower educational attainment, lower-income region of residence, medical comorbidities (obesity, diabetes and hypertension), first hospitalization at inpatient unit in comparison with the day hospital, higher total number of hospitalizations and the number of inpatient hospitalizations were found to serve as predictors of unemployment throughout the course of schizophrenia. After application of Bonferroni correction and logistic binary regression analysis, lower educational attainment, higher number of inpatient hospitalizations and obesity predicted unemployment.Conclusion:Education, obesity and the number of inpatient hospitalizations seem to predict vocational outcome in schizophrenia. This study warrants further investigation of medical comorbidities in schizophrenia in terms of social consequences in order to indicate the direction of this relationship.

Prevalence and correlates of job loss among schizophrenia outpatients at St. AmanuelMental Specialized Hospital, Addis Ababa, Ethiopia; cross sectional study

“…This might be due to in the severe stage of the illness behavioral and thought disorganization are prominent which affects functional involvement. This was consistent with studies conducted in Poland [22] and the European schizophrenia cohort study (EURO SC) [28].…”

“…duration of the study and previous job status of the participants in which ours were only those who had job during first diagnosis. This study was slightly lower than the study done in Poland which was 43.9% [22]. The possible reason might be due to accesses of higher training and job position in developed nations require increased mental functioning that is difficult for schizophrenia patients to maintain their job.…”

“…in London reports a high initial employment rate fall from 65% to 49% at 2 years [20]. It was 27% in the longitudinal study of West Birmingham UK [21], 44.2% in the cross sectional study of Poland [22] and 40.7% in china [23]. Some studies in employment status and schizophrenia identified the possible associated factors which were; co-morbidity comprising mental and physical illness [24], Occupational type [21], age of onset of illness [22], being male [25], being unmarried [16,26], low level of education [27], and older age [22,23,28], poor social skills [25,29,30], severity of symptoms and perceived stigma [31].…”

Vocational Profile and Correlates of Employment in People With Schizophrenia: The Role of Avolition

“…The rate of employment in our sample is higher than the rates reported in previous studies in developed countries (11)(12)(13)(14)(15)(16)(17), but lower than the rate reported in an urban area in India (19). In general, Singapore has a low unemployment rate (39,40) and Warner (41) had proposed that employment rate in people with schizophrenia may be associated with the prevailing economic condition and unemployment rate in the general population.…”

“…Illness onset during adolescence and early adulthood (9) interferes with an individual's vocational development such as education and employment (10). Among people with schizophrenia, the reported employment rate ranged from 10.2% in Norway to 30.3% in Germany (11)(12)(13)(14)(15)(16)(17). Employment rate was higher in developing countries, Asia (18,19), and in rural areas (13,18,20).…”