Tapfumaneyi Andrew, Johnson Sonia, Joyce John, Major Barnaby, Lawrence Jo, Mann Farhana, Chisholm Brock, Rahaman Nikola, Wooley James, Fisher Helen L
Lewisham Early Intervention Service, South London and Maudsley NHS Foundation Trust, London, UK.
Camden and Islington Early Intervention Service, Camden and Islington NHS Foundation Trust, London, UK.
Early Interv Psychiatry. 2015 Dec;9(6):447-58. doi: 10.1111/eip.12125. Epub 2014 Feb 20.
Work and educational activities are an important part of recovery for young people with psychosis, and improving vocational outcomes is a key target for early intervention services (EIS). This study evaluated predictors of vocational activity for first-episode psychosis (FEP) patients during the first year of EIS care. It was hypothesized that longer duration of untreated psychosis (DUP) and minority ethnic status would predict poorer vocational outcomes, whereas a history of good vocational functioning would predict better vocational functioning during follow up.
FEP patients aged 14-35 years, who presented to seven EIS in London, UK, between 2003 and 2010, were followed for 1 year. Sociodemographic, clinical and vocational information (qualifications obtained and paid employment) were collected using the MiData audit tool at entry to EIS and 1 year later.
Approximately one-third of patients (n = 345/1013) were studying or employed at some point during the first year of EIS care. Baseline vocational activity was the strongest predictor of vocational functioning during 1 year of follow up. Moreover, employment prior to entry into EIS strongly predicted change in vocational activity during 1 year of follow up. Individuals with DUP <6 months or of Asian or black African origin were more likely to be studying than their white British counterparts.
This study confirms that a significant proportion of FEP patients are able to engage in meaningful vocational activities even within the first year of EIS care. However, services need to focus more resources on getting patients with poor educational or employment histories into training programmes to improve their vocational outcomes.
工作和教育活动是精神病青年患者康复的重要组成部分,改善职业结局是早期干预服务(EIS)的关键目标。本研究评估了首次发作精神病(FEP)患者在EIS护理的第一年中职业活动的预测因素。研究假设未治疗精神病的持续时间(DUP)较长和少数族裔身份会预测较差的职业结局,而良好职业功能的病史会预测随访期间更好的职业功能。
对2003年至2010年间在英国伦敦的七个EIS就诊的14至35岁的FEP患者进行了为期1年的随访。在进入EIS时和1年后,使用MiData审核工具收集社会人口统计学、临床和职业信息(获得的学历和有偿就业情况)。
在EIS护理的第一年中,约三分之一的患者(n = 345/1013)在某个时间点在学习或就业。基线职业活动是随访1年期间职业功能的最强预测因素。此外,进入EIS之前的就业情况强烈预测了随访1年期间职业活动的变化。DUP<6个月的个体或亚洲或非洲黑人血统的个体比英国白人更有可能在学习。
本研究证实,即使在EIS护理的第一年,相当一部分FEP患者也能够参与有意义的职业活动。然而,服务需要将更多资源集中在让教育或就业历史不佳的患者参加培训项目上,以改善他们的职业结局。