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Majuri T, Nerg I, Huikari S, Rissanen I, Jääskeläinen E, Miettunen J, Korhonen M. Productivity costs of schizophrenia spectrum and other psychotic disorders by friction cost and human capital methods: The Northern Finland Birth Cohort 1966. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02652-y. [PMID: 38517515 DOI: 10.1007/s00127-024-02652-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/07/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE Psychotic disorders are associated with substantial productivity costs; however no previous studies have compared these between schizophrenia spectrum (SSD) and other psychotic disorders (OP). The human capital method (HCM) and the friction cost method (FCM) are the two most common approaches to assess productivity costs. The HCM focuses on employees' perspectives on the costs, whereas the FCM demonstrates employers' perspectives. Studies comparing these methods when estimating the productivity costs of psychoses are lacking. METHODS Utilizing the Northern Finland Birth Cohort 1966 with linkages to national registers, we compared the adjusted productivity costs of SSD (n = 216) and OP (n = 217). The productivity costs were estimated from ages 18 to 53 including projections to statutory retirement age using the FCM and HCM. RESULTS When estimated via the HCM, productivity losses were higher for SSD (€193,940) than for OP (€163,080). However, when assessed using the FCM, costs were significantly lower for SSD (€2,720) than for OP (€4,430). Productivity costs varied by sex and various clinical and occupational factors. CONCLUSION This study highlights how productivity costs vary by psychosis diagnosis. These differences should be noted when planning interventions. The low FCM estimates indicate the need of interventions before or during the early phases of psychoses. From a societal perspective, interventions are needed, particularly for those with highest HCM productivity losses, such as males with SSD. Besides psychiatric services, the roles of social services, employment agencies and occupational health care should be considered when helping individuals with psychoses to working life.
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Affiliation(s)
- Tuomas Majuri
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
| | - Iiro Nerg
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, Finland
| | - Sanna Huikari
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, Finland
| | - Ina Rissanen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Erika Jääskeläinen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marko Korhonen
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, Finland
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Tolonen J, Jääskeläinen E, Kiviniemi L, Majuri T, Haapea M, Miettunen J, Moilanen K. Functioning, psychiatric symptoms and quality of life of individuals with severe mental disorders after psychiatric rehabilitation. Nord J Psychiatry 2024; 78:54-63. [PMID: 37815430 DOI: 10.1080/08039488.2023.2262448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE Psychiatric disorders may have a negative effect on individuals' living, forming intimate relationships, education, and employment. The aim of psychiatric rehabilitation is to promote recovery - finding ways to cope with mental disorders despite debilitating symptoms. This study aimed to explore the outcomes of accommodation, social inclusion, psychiatric symptoms, substance and service use, quality of life and subjective recovery of young adults with severe mental illness after psychiatric rehabilitation. MATERIALS AND METHODS The study population consisted of individuals who had been in residential psychiatric rehabilitation between the ages of 18-29 years. Data on outcomes were collected using a questionnaire after a flexible follow-up period (mean 29 months). The questionnaire was answered by 32 eligible persons. We analysed multiple outcomes and compared the proportion of persons living independently at the start, after psychiatric rehabilitation, and at the follow-up point. RESULTS At the start of the rehabilitation, 33%, at the end, 69%, and at follow-up, 78% lived independently. However, most had not reached competitive employment nor were studying. Cognitive symptoms were the most common psychiatric symptoms, followed by depressive symptoms. More than 80% of the sample felt that they had partly recovered from their severe mental illness. CONCLUSION According to the results of this study residential psychiatric rehabilitation may have positive effects on functioning and independent living at follow-up. Reaching competitive employment is difficult for persons with severe mental disorders and effective rehabilitation interventions need to be implemented. However, this study had limitations, and these results should be considered preliminary.
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Affiliation(s)
- Jonna Tolonen
- Humana Sähäkkä Ltd., Ylivieska, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | | | - Tuomas Majuri
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Marianne Haapea
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kristiina Moilanen
- Humana Sähäkkä Ltd., Ylivieska, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Majuri T, Haapea M, Nordström T, Säynäjäkangas V, Moilanen K, Tolonen J, Ala-Mursula L, Miettunen J, Jääskeläinen E. Effect of onset age on the long-term outcome of early-onset psychoses and other mental disorders: a register-based Northern Finland Birth Cohort 1986 study. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02279-5. [PMID: 37568059 DOI: 10.1007/s00787-023-02279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
Psychiatric illnesses can affect the social transitions of adolescence and young adulthood, such as completing education and entering working life and relationships. However, associations between earlier onset age and long-term outcomes among those with early-onset psychoses (EOP) are unclear, as are the long-term outcomes of EOP compared to non-psychotic disorders. We used national register data of the Northern Finland Birth Cohort 1986 to detect persons with EOP and other early-onset psychiatric disorders. The long-term clinical and work-family outcomes of persons with onset age before 18 years (n = 41 psychoses, n = 495 non-psychoses) or between 18-22 years (n = 61 psychoses, n = 377 non-psychoses) were compared. Individuals with the onset of psychosis between 18-22 years had significantly more unfavourable long-term outcomes when compared to those with psychosis onset before 18 years. Persons with psychosis onset before the age of 18 years had similar outcomes to those with non-psychotic psychiatric disorder onset before 18 years regarding educational level, marital status, having children, and substance use disorders. Individuals with EOP were more often on a disability pension compared to those with other early-onset mental disorders. Adjusting for sex, educational level and substance use only slightly diluted these results. Unexpectedly, later onset age of EOP was associated with worse outcomes. Those with psychosis onset between 18-22 years of age are in a critical period, which underlines the importance of investing on interventions in this age group. Further studies on the effect of the onset age on later outcomes in EOP are needed.
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Affiliation(s)
- Tuomas Majuri
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland.
| | - Marianne Haapea
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Tanja Nordström
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Infrastructure for Population Studies, Northern Finland Birth Cohorts, University of Oulu, Arctic Biobank, Oulu, Finland
| | - Veera Säynäjäkangas
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
| | | | - Jonna Tolonen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
| | - Leena Ala-Mursula
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, P.O.BOX 5000, 90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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