Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Soc Psychiatry Psychiatr Epidemiol. 2012 May;47(5):797-803. doi: 10.1007/s00127-011-0386-4. Epub 2011 May 4.
Although it is well established that people with schizophrenia have markedly high rates of unemployment, less is known about the prevalence and clinical correlates of unemployment in patients newly diagnosed with first-episode psychosis. This analysis documented the prevalence of unemployment and examined previously reported clinical correlates of unemployment in patients with first-episode psychosis hospitalized in an urban, public-sector setting in the southeastern US.
Participants (n = 181) were assessed as part of an overarching study of first-episode psychosis using a variety of standardized research instruments. The rate of unemployment was compared to that documented in the general population according to US census data. Bivariate tests of associations between employment status and a number of variables of interest were followed by a multiple logistic regression model based on a previous study from Dublin, Ireland.
Some 65.0% of first-episode patients were unemployed in the month prior to hospital admission, which is substantially higher than the rate of unemployment during the same period in the two counties in which recruitment took place. In bivariate tests, unemployment was associated with younger age, fewer years of educational attainment, lower global functioning scores, and more severe negative symptoms. In the logistic regression model, only age and global functioning were independently significant correlates.
The remarkably high rate of unemployment in this young, first-episode sample, and the evidence of associations between unemployment, greater symptomatology, and poorer functioning, argue for further research and development on supported employment programs for such patients.
尽管精神分裂症患者的失业率明显较高已得到充分证实，但对于首次发作精神分裂症患者的失业率及其临床相关因素知之甚少。本分析记录了首次发作精神分裂症患者的失业率，并检验了美国东南部城市公共部门住院患者中先前报告的与失业相关的临床因素。
参与者（n=181）作为首次发作精神分裂症的综合研究的一部分，使用各种标准化研究工具进行评估。根据美国人口普查数据，将失业率与一般人群中的失业率进行比较。在进行多元逻辑回归模型之前，首先对就业状况与一些感兴趣的变量之间的关联进行了双变量检验，该模型基于爱尔兰都柏林的一项先前研究。
在入院前的一个月内，约 65.0%的首发患者失业，这大大高于在招募发生的两个县同期的失业率。在双变量检验中，失业与年龄较小、受教育年限较短、总体功能评分较低和更严重的阴性症状有关。在逻辑回归模型中，只有年龄和总体功能是独立的显著相关因素。
在这个年轻的首发样本中，失业率高得惊人，并且失业与症状加重和功能下降之间存在关联的证据，这表明需要进一步研究和开发针对此类患者的支持性就业计划。
