Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders.

IF 3.9 3区医学 Q1 PSYCHIATRY

BJPsych Open Pub Date : 2024-12-26 DOI:10.1192/bjo.2024.816

Fanny Senner, Lisa Kerkhoff, Kristina Adorjan, Michael Lauseker, Monika Budde, Maria Heilbronner, Janos L Kalman, Mojtaba Oraki Kohshour, Sergi Papiol, Daniela Reich-Erkelenz, Sabrina K Schaupp, Eva C Schulte, Thomas Vogl, Ion-George Anghelescu, Volker Arolt, Bernhardt T Baune, Udo Dannlowski, Nina Dalkner, Detlef E Dietrich, Andreas J Fallgatter, Christian Figge, Carsten Konrad, Fabian U Lang, Jens Reimer, Eva Z Reinighaus, Max Schmauß, Andrea Schmitt, Simon Senner, Carsten Spitzer, Jörg Zimmermann, Alkomiet Hasan, Peter Falkai, Thomas G Schulze, Urs Heilbronner, Sophie-Kathrin Greiner

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引用次数: 0

Abstract

Background: Employment and relationship are crucial for social integration. However, individuals with major psychiatric disorders often face challenges in these domains.

Aims: We investigated employment and relationship status changes among patients across the affective and psychotic spectrum - in comparison with healthy controls, examining whether diagnostic groups or functional levels influence these transitions.

Method: The sample from the longitudinal multicentric PsyCourse Study comprised 1260 patients with affective and psychotic spectrum disorders and 441 controls (mean age ± s.d., 39.91 ± 12.65 years; 48.9% female). Multistate models (Markov) were used to analyse transitions in employment and relationship status, focusing on transition intensities. Analyses contained multiple multistate models adjusted for age, gender, job or partner, diagnostic group and Global Assessment of Functioning (GAF) in different combinations to analyse the impact of the covariates on the hazard ratio of changing employment or relationship status.

Results: The clinical group had a higher hazard ratio of losing partner (hazard ratio 1.46, P < 0.001) and job (hazard ratio 4.18, P < 0.001) than the control group (corrected for age/gender). Compared with controls, clinical groups had a higher hazard of losing partner (affective group, hazard ratio 2.69, P = 0.003; psychotic group, hazard ratio 3.06, P = 0.001) and job (affective group, hazard ratio 3.43, P < 0.001; psychotic group, hazard ratio 4.11, P < 0.001). Adjusting for GAF, the hazard ratio of losing partner and job decreased in both clinical groups compared with controls.

Conclusion: Patients face an increased hazard of job loss and relationship dissolution compared with healthy controls, and this is partially conditioned by the diagnosis and functional level. These findings underscore a high demand for destigmatisation and support for individuals in managing their functional limitations.

查看原文本刊更多论文

失而复得：情感和精神病谱系障碍患者的关系和就业状况随时间的动态变化。

背景：就业和关系对社会融合至关重要。然而，患有严重精神障碍的个体经常在这些领域面临挑战。目的：我们调查了情感和精神病谱系患者的就业和关系状态变化，并与健康对照进行比较，检查诊断组或功能水平是否影响这些转变。方法：来自纵向多中心心理病程研究的样本包括1260例情感性和精神谱系障碍患者和441例对照组(平均年龄±s.d, 39.91±12.65岁；48.9%的女性)。使用多状态模型（马尔科夫）来分析就业和关系状态的转变，重点关注转变强度。分析包含对年龄、性别、工作或伴侣、诊断组和整体功能评估（GAF）进行不同组合调整的多个多状态模型，以分析协变量对改变就业或关系状态的风险比的影响。结果：临床组失去伴侣的风险比（风险比1.46,P < 0.001）和工作的风险比（风险比4.18,P < 0.001）高于对照组（校正年龄/性别）。与对照组相比，临床组失去伴侣的风险更高(情感组，风险比2.69,P = 0.003；精神病组，风险比3.06,P = 0.001)和情感组，风险比3.43,P < 0.001；精神病组，风险比4.11,P < 0.001)。调整GAF后，与对照组相比，两个临床组失去伴侣和工作的风险比都下降了。结论：与健康对照组相比，患者面临更高的失业和关系破裂风险，这部分取决于诊断和功能水平。这些发现强调了消除歧视和支持个人管理其功能限制的高度需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BJPsych Open Medicine-Psychiatry and Mental Health

CiteScore

6.30

自引率

3.70%

发文量

610

审稿时长

16 weeks

期刊介绍： Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.