Occupational and other outcomes in schizophrenia and other psychoses

• Main Author: Majuri, T. (Tuomas)
• Other Authors: Jääskeläinen, E. (Erika), Miettunen, J. (Jouko), Haapea, M. (Marianne)
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Oulun yliopisto 2023
• Subjects: cohort studies; disability pension; early-onset psychosis; employment; follow-up studies; labour market; outcome; prognosis; psychotic disorders; recovery; schizophrenia; trajectory; work; ammatillinen ennuste; ennusteet; kehityskaari; kohorttitutkimus; psykoottiset häiriöt; seurantatutkimus; skitsofrenia; toipuminen; työ; työkyvyttömyyseläkkeet; työmarkkinat; työssäolo; varhain puhjennut psykoosi; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526236155

Abstract Schizophrenia and other psychoses are psychiatric disorders that are often associated with relatively poor outcomes. Occupational and other outcomes in psychotic disorders are typically the worst of all psychiatric disorders. However, data on these outcomes in long-term follow-up periods are scarce. The study aimed to investigate long-term occupational and other outcomes in schizophrenia and other psychoses by utilising national register data and questionnaire data from different ages. Outcomes were studied longitudinally at three different stages of illness including onset, over the course of working life, and after years of disability pension. The study was based on the general population-based Northern Finland Birth Cohorts 1966 and 1986. Persons with psychosis onset at 18–22 years of age had poorer long-term outcomes in terms of marital status, having children, and having substance use disorders compared to psychosis onset before 18 years. People with psychosis onset before the age of 18 years had mainly similar socioeconomic and clinical outcomes compared to non-psychotic psychiatric disorders with onset before 18 years. However, persons with early-onset psychosis were more often on disability pension compared to other early-onset psychiatric disorders. Most individuals with schizophrenia and other psychoses presented with unfavourable employee trajectories reflecting an elevated risk of unemployment and part-time work until midlife. Although schizophrenia is associated with long-term work disability, it is possible to return to the labour market after being on a disability pension. In other psychoses, returning to the labour market is more common than in schizophrenia. In schizophrenia, being married, later onset age of psychosis, shorter length of the latest disability pension and better school performance, and in other psychoses, having children and shorter length of the latest disability pension predicted returning to the labour market. The study showed that people with psychosis onset before ...