Turner Niall, Browne Stephen, Clarke Mary, Gervin Maurice, Larkin Conall, Waddington John L, O'Callaghan Eadbhard
Detect Early Psychosis Service, Avila House, Block 5, Blackrock Business Park, Carysfort Ave., Blackrock, Co. Dublin, Ireland.
Soc Psychiatry Psychiatr Epidemiol. 2009 Oct;44(10):863-9. doi: 10.1007/s00127-009-0008-6. Epub 2009 Mar 3.
Employment is generally beneficial to health and quality of life. Despite many advances in the treatment of psychosis there are continuing reports of high levels of unemployment. In most studies of first episode psychosis (FEP) only rudimentary rates of employment are provided. We sought to establish the prevalence of employment amongst those with FEP from a geographically defined area, to compare employment categories for differences in demographical and clinical characteristics and finally, to examine factors associated with employment.
All cases of FEP were assessed from a defined suburban area with a structured clinical interview for DSM-III-R diagnosis and a standardised assessment protocol. Employment status was divided into employed, non-labour force work and unemployed.
Of 162 cases of psychosis, those employed (46%) were indistinguishable from those in non-labour force work (21%). Those unemployed (33%) had significantly longer DUP, more negative symptoms and lower quality of life than those engaged in non-labour force work or those employed. Having a non-affective psychosis (chi(2) = 0.05, OR = 1.2; 95% CI 1.0, 1.4) was associated with being unemployed at presentation. Better (beta = -0.2, P = 0.00) academic premorbid adjustment was associated with being employed at presentation.
Although 67% of those with FEP from a geographically defined area are engaged in purposeful work, the rate of unemployment is nine times the local rate. Longer DUP and negative symptoms are associated with unemployment at presentation. Standardised reporting of employment status would greatly assist research in this area.
就业通常对健康和生活质量有益。尽管在精神病治疗方面取得了许多进展，但仍不断有高失业率的报道。在大多数首发精神病（FEP）研究中，仅提供了基本的就业率。我们试图确定来自特定地理区域的FEP患者的就业患病率，比较不同就业类别在人口统计学和临床特征方面的差异，最后研究与就业相关的因素。
对来自特定郊区的所有FEP病例进行评估，采用结构化临床访谈进行DSM-III-R诊断，并采用标准化评估方案。就业状况分为就业、非劳动力工作和失业。
在162例精神病患者中，就业者（46%）与非劳动力工作者（21%）没有明显差异。失业者（33%）的疾病发作前持续时间（DUP）明显更长，阴性症状更多，生活质量低于非劳动力工作者或就业者。患有非情感性精神病（卡方=0.05，比值比=1.2；95%置信区间1.0，1.4）与就诊时失业有关。病前学业适应更好（β=-0.2，P=0.00）与就诊时就业有关。
尽管来自特定地理区域的FEP患者中有67%从事有目的的工作，但失业率是当地失业率的九倍。较长的DUP和阴性症状与就诊时失业有关。就业状况的标准化报告将极大地有助于该领域的研究。
