How is employment related to schizophrenia?

Employment rates are typically low and can be used as a measure of social disability in schizophrenia. Employment function is commonly assessed using outcomes such as rates of employment, success in getting and keeping employment, as well as patient characteristics and the treatments received. Low rates of employment among people with schizophrenia places extended burden on social support and disability services, and significantly affects quality of life. Employment rates may be improved by greater focus on patient education and opportunities for supported employment.

What is the evidence regarding employment?

Reviews with moderate or moderate to high quality evidence show people with schizophrenia are less likely to attain employment and retain it after 3 months than people with other mental disorders. Rates of employment vary considerably, ranging from 4% to 60% in Europe, and from 13% to 80% in the developing world. Rates of employment after a first episode of psychosis range from 13% to 65%. Being employed is consistently related to reductions in outpatient psychiatric treatment and in improved self-esteem, and inconsistently related to fewer psychiatric hospitalisations, less medication, better life satisfaction, and improved wellbeing.

Reviews with moderate or moderate to low quality evidence suggest receiving public support or disability income, having negative symptoms such as social withdrawal, or being young are related to lower rates of competitive employment. Other barriers to employment include illness stigmatisation, economic disincentives, low self-esteem, and poor cognitive functioning. Factors related to higher rates of employment include being married or being in a defacto relationship, receiving medical treatment, or having a work history.

Reviews with moderate or moderate to low quality evidence suggest overall vocational interventions are beneficial for improving employment rates and work function in people with schizophrenia.

August 2020

Last updated at: 3:01 am, 12th August 2020
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