Identifying improvable employment-related factors in schizophrenia patients

Triangulation study of needs assessment of people with severe mental illness in “follow‐up” day hospital settings

AIM

The aim of research was to assess the needs of patients with severe mental illness (SMI) attending follow-up day hospital (DH) programmes from the patients', relatives' and experts' perspective.

DESIGN

This triangulation research relies on three sources of information and two techniques of data collection.

METHODS

Qualitative research was conducted comprising semi-structured interviews (n = 15) and focus groups (n = 4) in three sequential rounds, triangulating patients', relatives' and experts' views. A content analysis was carried out.

RESULTS

Study reveals a diverse spectrum of needs of SMI patients in follow-up DH programmes. The analysis yielded six themes: optimal daily functioning, work and educational activities, social network inclusion, continuous treatment, support and guidance, long-term care. DH programmes should assess the needs of patients with SMI and be adapted according to the findings. In addition to clinical treatment, requirements for continuous treatment, psychological and social needs, therapeutic relationship in less-restrictive settings should be considered.

The Factors Affecting the Relationship between Remission Status and Employment in Chronic Schizophrenia Patients

OBJECTIVE

Symptomatic remission have substantial effects in long-term schizophrenia outcome, but exact determinants of the employment. In this study, the relationship between employment and symptomatic remission in chronic schizophrenia patients and other factors related to employment were investigated.

METHODS

100 patients interviewed were evaluated by the Positive and Negative Syndrome Scale (PANSS), Functional Recovery Scale in Schizophrenia (FROGS), Global Assessment of Functioning (GAF), Quality of Life Scale (QoL) and Subjective Recovery Assessment Scale (SubRAS). Sociodemographic variables, clinical features, antipsychotic dose and past working history obtained from patient interviews were investigated.

RESULTS

The patients of 40% who participate in the study were symptomatic remission, but only 53.5% of these patients weren't employed. Young age, especially, -regardless of the onset of illness- working a job in the past, low and moderate use CPED (equivalent doses according to chlorpromazine), shorter disease duration, symptomatic remission was found to be closely related to employment. While QoL, FROGS, GAF, and SubRAS total scores of employment group were higher than the unemployment group, PANSS total scores in the unemployment group were higher than that of the employment group. There was a high correlation between the scales and employment status.

CONCLUSION

Employment status was closely related with the remission status. This study supports that symptomatic remission alone is not decisive for employment. It was found that younger age, past working history (before or after the disease), low and intermediate CPED antipsychotic use and shorter duration of disease were closely related to employment with symptomatic remission.