Social Functioning, Treatment With Antipsychotic Agents Associated With Employment in Schizophrenia

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Patients with schizophrenia who were employed had more years of education and a shorter duration of disease.
Patients with schizophrenia who were employed had more years of education and a shorter duration of disease.

Study results published in Psychiatry Research suggest that treatment targeting social functioning along with antipsychotic agents could improve employability for patients with schizophrenia.

Researchers conducted interviews with 235 individuals with schizophrenia or schizoaffective disorder who were being treated at 3 outpatient facilities in Japan. The Global Assessment of Psychopathology Scale (GAPS) and the Social and Occupational Functioning Assessment Scale (SOFAS) were used to assess symptomatology and social functioning in the first year of treatment. Medical record review was used to capture daily antipsychotic use and other clinical features. Of the total number of participants in this cohort (n=235), 129 individuals reported employment and 106 were unemployed.

Compared with the unemployed group, employed individuals showed significant improvements in SOFAS scores at 6 (P =.018) and 12 months (P =.002) after treatment initiation.  Similarly, employed patients also showed greater improvements in GAPS scores compared with unemployed patients at the 6-month (P =.0015) and 12-month (P =.0002) timepoints. Per multivariable logistic regression analyses, both SOFAS (P =.011) and GAPS score (P <1.0 × 10−6) improvements between 6 and 12 months after initiating treatment were predictive of employment. Additional employment-related factors were low-to-moderate daily antipsychotic doses (P =.004), male sex (P =.006), low Positive and Negative Syndrome Scale negative symptom scores (P <1.0 × 10−6), high Calgary Depression Scale for Schizophrenia total scores (P =.001), and shorter disease duration (P =.005), per logistic regression analyses using SOFAS scores.

According to these data, improved social functioning during treatment course and low-to-moderate daily antipsychotic drug use are strongly associated with employment. As such, clinician efforts to improve social capacity and optimize antipsychotic dose may assist patients in obtaining employment. 

Reference

Hasegawa T, Hashimoto T, Kanahara N, et al. Identifying improvable employment-related factors in schizophrenia patients. Psychiatry Res. 2018;266:199-205.

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