Luciano Alison, Meara Ellen
Psychiatr Serv. 2014 Oct;65(10):1201-9. doi: 10.1176/appi.ps.201300335.
The aim of this study was to describe employment according to mental illness severity in the United States during 2009 and 2010.
The sample included all working-age participants (ages 18-64) from the 2009 and 2010 National Survey on Drug Use and Health (N=77,326). Two well-established scales of mental health distinguished participants with none, mild, moderate, and serious mental illness. Analyses compared employment rate and income by mental illness severity. Employment status was estimated with logistic regression models that controlled for demographic characteristics and substance use disorders. In secondary analyses the relationship between mental illness and employment was assessed for variation by age and education status.
Employment rates decreased with increasing mental illness severity (no mental illness, 75.9% employment; mild, 68.8%; moderate, 62.7%; and serious, 54.5%, p<.001). Over a third of people with serious mental illness, 38.5%, had incomes <$10,000 (compared with 23.1% of people with no mental illness, p<.001). The gap in adjusted employment rates comparing persons with serious versus no mental illness was 1% among people 18-25 years old versus 21% among people 50-64 (p<.001).
More severe mental illness was associated with lower employment rates in 2009 and 2010. People with serious mental illness are less likely than people with no, mild, or moderate mental illness to be employed after age 49.
本研究旨在描述2009年至2010年美国按精神疾病严重程度划分的就业情况。
样本包括2009年和2010年全国药物使用和健康调查中所有工作年龄的参与者(18 - 64岁,N = 77326)。两种成熟的心理健康量表区分了无精神疾病、轻度、中度和重度精神疾病的参与者。分析比较了按精神疾病严重程度划分的就业率和收入。使用控制人口统计学特征和物质使用障碍的逻辑回归模型估计就业状况。在二次分析中,评估了精神疾病与就业之间的关系在年龄和教育状况方面的差异。
就业率随着精神疾病严重程度的增加而下降(无精神疾病,就业率75.9%;轻度,68.8%;中度,62.7%;重度,54.5%,p <.001)。超过三分之一的重度精神疾病患者(38.5%)收入低于10000美元(无精神疾病者为23.1%,p <.001)。18 - 25岁人群中,重度与无精神疾病者调整后就业率的差距为1%,而50 - 64岁人群中这一差距为21%(p <.001)。
2009年至2010年,更严重的精神疾病与更低的就业率相关。49岁以后,重度精神疾病患者比无精神疾病、轻度或中度精神疾病患者就业的可能性更小。