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Ten-year employment patterns of patients with first-episode schizophrenia-spectrum disorders: comparison of early intervention and standard care services

Published online by Cambridge University Press:  09 July 2019

Sherry Kit Wa Chan
Affiliation:
Clinical Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
Herbert H. Pang
Affiliation:
Assistant Professor, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Kang K. Yan
Affiliation:
PhD student, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Christy Lai Ming Hui
Affiliation:
Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Yi Nam Suen
Affiliation:
Research Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Wing Chung Chang
Affiliation:
Clinical Associate Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
Edwin Ho Ming Lee
Affiliation:
Clinical Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
Pak Sham
Affiliation:
Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
Eric Yu Hai Chen
Affiliation:
Clinical Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
Corresponding
E-mail address:

Abstract

Background

Little is known about long-term employment outcomes for patients with first-episode schizophrenia-spectrum (FES) disorders who received early intervention services.

Aims

We compared the 10-year employment trajectory of patients with FES who received early intervention services with those who received standard care. Factors differentiating the employment trajectories were explored.

Method

Patients with FES (N = 145) who received early intervention services in Hong Kong between 1 July 2001 and 30 June 2002 were matched with those who entered standard care 1 year previously. We used hierarchical clustering analysis to explore the 10-year employment clusters for both groups. We used the mixed model test to compare cluster memberships and piecewise regression analysis to compare the employment trajectories of the two groups.

Results

There were significantly more patients who received the early intervention service in the good employment cluster (early intervention: N = 98 [67.6%]; standard care: N = 76 [52.4%]; P = 0.009). In the poor employment cluster, there was a significant difference in the longitudinal pattern between early intervention and standard care for years 1–5 (P < 0.0001). The number of relapses during the first 3 years, months of full-time employment during the first year and years of education were significant in differentiating the clusters of the early intervention group.

Conclusions

Results suggest there was an overall long-term benefit of early intervention services on employment. However, the benefit was not sustained for all patients. Personalisation of the duration of the early intervention service with a focus on relapse prevention and early vocational reintegration should be considered for service enhancement.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 2019

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Footnotes

Declaration of interests: No relevant conflicts of interests reported by C.L.M.H., Y.N.S., P.S., H.H.P. and K.K.Y. S.K.W.C., W.C.C. and E.H.M.L. report that they are members of the working group of the Early Assessment Service for Young People with Psychosis (EASY) programme of the Hospital Authority in Hong Kong. E.Y.H.C. is the convener of the working group of the EASY programme of the Hospital Authority in Hong Kong.

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