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心理治疗和以工作为导向的干预措施:因精神障碍导致工作残疾的年轻人的就业结果。

Psychotherapeutic and work-oriented interventions: employment outcomes among young adults with work disability due to a mental disorder.

作者信息

Mattila-Holappa Pauliina, Joensuu Matti, Ahola Kirsi, Koskinen Aki, Tuisku Katinka, Ervasti Jenni, Virtanen Marianna

机构信息

Finnish Institute of Occupational Health, Töölöntullinkatu 8, 00250 Helsinki, Finland.

Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Int J Ment Health Syst. 2016 Oct 12;10:68. doi: 10.1186/s13033-016-0101-7. eCollection 2016.

Abstract

BACKGROUND

We examined the extent to which psychotherapeutic and work-oriented interventions were included in a medical treatment and rehabilitation plan and whether they predicted future employment among young adults with work disability due to a mental disorder.

METHODS

Data were obtained from the treatment and rehabilitation plans of 1163 young adults aged 18‒34 years, who in 2008 were granted fixed-term work disability compensation due to a mental disorder and were followed for 5 years.

RESULTS

Forty-six percent had no proposal for psychotherapy or a work-oriented intervention in their treatment and rehabilitation plan, 22 % had a plan for only a psychotherapeutic intervention, 23 % had a plan for only a work-oriented intervention, and 10 % had both types of interventions planned. Having a planned psychotherapeutic intervention (HR = 1.35, 95 % CI 1.07-1.69) and of the work-oriented interventions, planned rehabilitative courses and training (HR = 1.34, 95 % CI 1.03-1.70) predicted quicker entry into competitive employment. Having a plan for both a psychotherapeutic and work-oriented intervention was associated with being employed at the end of the follow-up (OR = 1.77, 95 % CI 1.07-2.95).

CONCLUSIONS

Young adults with a long-term psychiatric work disability episode rarely have a recorded plan for rehabilitation in their treatment and rehabilitation plan although psychotherapeutic interventions and a combination of a psychotherapeutic and work-oriented intervention might help them gain employment.

摘要

背景

我们研究了心理治疗和工作导向型干预在医疗治疗与康复计划中的纳入程度,以及它们是否能预测因精神障碍导致工作残疾的年轻人未来的就业情况。

方法

数据来自1163名年龄在18至34岁的年轻人的治疗与康复计划,这些人在2008年因精神障碍获得了定期工作残疾补偿,并接受了5年的随访。

结果

46%的人在其治疗与康复计划中没有心理治疗或工作导向型干预的提议,22%的人只有心理治疗干预计划,23%的人只有工作导向型干预计划,10%的人有两种干预计划。有计划的心理治疗干预(风险比=1.35,95%置信区间1.07-1.69)以及工作导向型干预中的康复课程和培训计划(风险比=1.34,95%置信区间1.03-1.70)预测能更快进入竞争性就业。有心理治疗和工作导向型干预计划与随访结束时就业相关(比值比=1.77,95%置信区间1.07-2.95)。

结论

患有长期精神疾病导致工作残疾的年轻人在其治疗与康复计划中很少有记录在案的康复计划,尽管心理治疗干预以及心理治疗与工作导向型干预相结合可能有助于他们获得就业。

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