Employment and income conditions among individuals with non-affective psychosis in Stockholm, Sweden
Year: 2014
Type: article
Study design: Observational Study
Abstract: Background Non-affective psychosis, e.g. schizophrenia, causes a high degree of disability and impaired social functioning. The disease usually strikes people at young ages, 20-30 years. Little is known about long-term social differentials among people with the disorders. This study investigated employment and income conditions among first incident cases of non-affective psychoses in Stockholm, one year before diagnosis and over time. Methods Longitudinal cohort data from Stockholm county comprised people aged 18-44 yr with first incident non-affective psychosis (ICD-10 F20-F29), registered in in- or outpatient care 2005/06, in the Psychiatric Care System (N = 756, men 55.7%). The study population was followed up until 2010 regarding non-employment, disability pension, social assistance and low disposable income by linkage to social data. Age-standardised rates were calculated. Odds ratios (ORs) 95% CIs were estimated using logistic regression. Results Already one year before diagnosis, rates of non-employment, disability pension and social assistance were higher compared to the general population. Disability pension rates doubled at follow-up most pronounced among women with compulsory school (68.7%). Trends of increased non-employment rates were found and high rates of social assistance remained during the whole follow-up. Significantly increasing rates of low disposable income were found over time for non-employed. At follow-up low disposable income was significantly higher for the youngest age group (men OR 1.9, CI 95% = 1.1-3.4; women OR 2.3, CI 95% = 1.2-4.4) and for foreign born women (OR 2.3, CI 95% = 1.3-4.0). No differentials were found in relation to education. Conclusions Non-employment and income vulnerability existed already one year before diagnosis presumably due to prodromal symptoms or untreated psychoses. These conditions worsened over time more for some social groups, and call for early preventive support to encourage employment and income security. Key messages Poor income and employment conditions among people with non-affective psychosis indicate vulnerability already before diagnosis and over time. The findings are worrying from a Swedish social policy perspective and call for early and preventative support to encourage employment and income security.
Authors: J Falk, B Burström, C Dalman, L Jörgensen, L Nylén
Institutions: Karolinska Institutet, Region Stockholm
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2588025405