Wenche Ten Velden Hegelstad1, Kolbjorn S Bronnick1, Helene Eidsmo Barder1, Julie Horgen Evensen1, Ulrik Haahr1, Inge Joa1, Jan Olav Johannessen1, Johannes Langeveld1, Tor Ketil Larsen1, Ingrid Melle1, Stein Opjordsmoen1, Bjørn Rishovd Rund1, Jan Ivar Rossberg1, Erik Simonsen1, Per Wiggen Vaglum1, Thomas H McGlashan1, Svein Friis1. 1. Dr. Hegelstad, Prof. Dr. Bronnick, Dr. Joa, Prof. Dr. Johannessen, Dr. Langeveld, and Prof. Dr. Larsen are with the Regional Centre for Clinical Research in Psychosis, Psychiatric Division, Stavanger University Hospital, Stavanger, Norway (e-mail: wenchetenvelden@mac.com ). Prof. Dr. Bronnick, Dr. Joa, and Prof. Dr. Johannessen are also with the Faculty of Social Sciences, University of Stavanger, Stavanger, Norway. Prof. Dr. Larsen is also with the Institute of Clinical Medicine, University of Bergen, Bergen, Norway. Dr. Barder is with the Women and Children's Division, and Prof. Dr. Friis is with the Division of Mental Health and Addiction, Oslo University Hospital, Oslo. Prof. Dr. Friis is also with the Institute of Clinical Medicine, University of Oslo, Oslo, where Prof. Dr. Melle, Prof. Dr. Opjordsmoen, and Prof. Dr. Rossberg are affiliated. Prof. Dr. Melle, Prof. Dr. Opjordsmoen, and Prof. Dr. Rossberg are also with the Division of Mental Health and Addiction, Oslo University Hospital, Ullevål, Oslo, where Dr. Evensen is affiliated. Dr. Haahr and Prof. Dr. Simonsen are with the Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Smedegade, Roskilde, Denmark. They are also with the Psychiatric Research Unit, Psychiatry Region Zealand, Toftegade, Roskilde, Denmark. Prof. Dr. Rund is with the Department of Psychology, and Prof. Dr. Vaglum is with the Department of Behavioral Sciences in Medicine, University of Oslo, Oslo. Prof. Dr. Rund is also with the Vestre Viken Hospital Trust, Drammen, Norway. Dr. McGlashan is with the School of Medicine, Yale University, New Haven, Connecticut.
Abstract
OBJECTIVE: This study tested the hypothesis that early detection of psychosis improves long-term vocational functioning through the prevention of negative symptom development. METHODS: Generalized estimating equations and mediation analysis were conducted to examine the association between employment and negative symptoms over ten years among patients in geographic areas characterized by usual detection (N=140) or early detection (N=141) of psychosis. RESULTS: Improved vocational outcome after ten years among patients in the early-detection area was mediated by lower levels of negative symptoms during the first five years. Regardless of symptoms, rates of full-time employment or study were lower among patients in the usual-detection versus the early-detection area. CONCLUSIONS: Patients from an early-detection area attained lower negative symptom levels earlier compared with patients from a usual-detection area, which seemed to have facilitated vocational careers.
OBJECTIVE: This study tested the hypothesis that early detection of psychosis improves long-term vocational functioning through the prevention of negative symptom development. METHODS: Generalized estimating equations and mediation analysis were conducted to examine the association between employment and negative symptoms over ten years among patients in geographic areas characterized by usual detection (N=140) or early detection (N=141) of psychosis. RESULTS: Improved vocational outcome after ten years among patients in the early-detection area was mediated by lower levels of negative symptoms during the first five years. Regardless of symptoms, rates of full-time employment or study were lower among patients in the usual-detection versus the early-detection area. CONCLUSIONS:Patients from an early-detection area attained lower negative symptom levels earlier compared with patients from a usual-detection area, which seemed to have facilitated vocational careers.