Schizophrenia and work: aspects related to job acquisition in a follow-up study

Abstract

Objective:Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition.Method:Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale – PANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression – CGI), functionality (Global Assessment of Functioning – GAF), personal and social performance (Personal and Social Performance – PSP) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia – MATRICS battery) were applied at baseline and at the end of the study.Results:Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS).Conclusions:Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.

Symptomatic remission affects employment outcomes in schizophrenia patients

“…In addition, we found PSP was significantly associated with cumulative duration of work in this study. This finding is compatible with prior studies, showing that a better psychosocial functioning is pertinent to a positive work role and job acquisition for patients with schizophrenia [22,27]. Our finding indicates that psychosocial functioning is associated with job tenure.…”

“…A global PSP score indicates the level of psychosocial functioning; a higher score means better functioning. Higher PSP scores were found to be significantly correlated with better employment status and a useful work role among patients with schizophrenia [22,27].…”

“…Although most people with psychiatric disabilities show a desire to work, they are more likely to experience adverse labor market outcomes due to symptom interference. However, employment contributes substantially to the quality and satisfaction of life is very important to patients with mental disorders [22]. A previous study recruiting 93 patients with first-episode schizophrenia revealed that symptomatic remission was significantly related to a higher employment rate at 1year and 12-year follow-up sessions [23].…”

“…Patients with schizophrenia who are employed consume a lower amount of medication, exhibit lower negative symptom severity and lower excitement symptom severity, and tend to achieve better global functioning [11,14,19]. Nevertheless, there were some limitations in prior studies elucidating symptom and employment outcomes, which follow: 1) The multivariate analysis did not control the important baseline confounders associated with employment status, such as type of antipsychotics [14,24], cognitive function [25], initial employment types [26], psychosocial functioning [22,27], social support and skills, previous history of successful employment [28], and intrinsic and extrinsic motivation [29]; and 2) There was not a clear definition of employment outcomes. Previous studies defined "full-time students" or "paid workers" as "occupied," [23] or defined "paid employment" by asking, "Did you work at a job for pay during the past 4 weeks?"…”

Symptomatic remission in schizophrenia affects employment outcomes; Instrumental activity of daily living is a determinant for non-remitted patients

“…However, employment contributes substantially to satisfaction and the meaning of life and has a very important meaning to patients with mental disorders [18]. A previous study recruiting 93 first-episode schizophrenia patients revealed that symptomatic remission was significantly related to a higher employment rate at 1-year and 12-year follow-up [19].…”