Employment and relationship outcomes in first-episode psychosis: A systematic review and meta-analysis of longitudinal studies

SCHIZOPHRENIA RESEARCH

卷:231

Review

Ajnakina, Olesya^1,2  Stubbs, Brendon^3,4  Francis, Emma²  Gaughran, Fiona^5,6  David, Anthony S.⁷  Murray, Robin M.^5,8  Lally, John^5,9,10 

[1] Univ London, Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Biostat & Hlth Informat, 16 De Crespigny Pk,Denmark Hill, London SE5 8AF, England

[2] UCL, Inst Epidemiol & Hlth Care, Dept Behav Sci & Hlth, London, England

[3] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol Med, London, England

[4] South London & Maudsley NHS Fdn Trust, Physiotherapy Dept, London, England

[5] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England

[6] South London & Maudsley NHS Fdn Trust, Natl Psychosis Serv, London, England

[7] UCL, Inst Mental Hlth, London, England

[8] Univ Palermo, Dept Psychiat Expt Biomed & Clin Neurosci BIONEC, Palermo, Italy

[9] Royal Coll Surgeons Ireland, Dept Psychiat, Dublin, Ireland

[10] St Vincents Hosp Fairview, Dept Psychiat, Dublin, Ireland

关键词: First-episode psychosis;    Schizophrenia;    Occupation;    Relationships;    Follow-up;    Recovery;   

DOI  :  10.1016/j.schres.2021.03.013

来源: Elsevier

【 摘 要 】

As employment and relationship status are important long-term outcomes in individuals with a diagnosis of first episode psychosis (FEP) disorders, there is a need to elucidate more accurately the extent of these social deficits in people with FEP. This in turn can aid treatment planning and policy development ultimately ensuring more complete and sustainable recoveries. We carried out a systematic review and meta-analysis of longitudinal studies in FEP reporting on employment and relationship status during the illness course. Random effects meta-analyses and meta-regression analyses were employed. Seventy-four studies were included with a sample totalling 15,272 (range = 20-1724) FEP cases with an average follow-up duration of 8.3 years (SD = 7.2). 32.5% (95%CI = 28.5-36.9) of people with a diagnosis of FEP disorders were employed and 21.3% (95%CI = 16.5-27.1) were in a relationship at the end of follow-up. Studies from high-income countries and Europe had a higher proportion of people in employment at the end of follow-up compared to middle-income nations and non-European countries. The inverse was found for relationship status. The proportion of people with a diagnosis of FEP in employment decreased significantly with longer follow-up. Living with family, being in a relationship at first contact and Black and White ethnicities were identified as significant moderators of these outcomes. These findings highlight marked functional recovery deficits for people with FEP, although cultural factors need to be considered. They support the need for interventions to improve employment opportunities, and social functioning, both in early psychosis and during the longitudinal illness course. Crown Copyright (c) 2021 Published by Elsevier B.V. All rights reserved.

【 授权许可】

Free