Eóin Killackey1, Kelly Allott2, Henry J Jackson3, Rosanna Scutella4, Yi-Ping Tseng4, Jeff Borland5, Tina-Marie Proffitt6, Sally Hunt7, Frances Kay-Lambkin8, Gina Chinnery9, Gennady Baksheev10, Mario Alvarez-Jimenez11, Patrick D McGorry12, Susan M Cotton13. 1. Professor of Functional Recovery in Youth Mental Health, Orygen,The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health,The University of Melbourne,Australia. 2. Senior Research Fellow, Orygen,The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health,The University of Melbourne,Australia. 3. Professor, Melbourne School of Psychological Sciences,The University of Melbourne,Australia. 4. Senior Research Fellow, Melbourne Institute,The University of Melbourne,Australia. 5. Professor, Melbourne Institute and Department of Economics,The University of Melbourne,Australia. 6. Research Fellow and Neuropsychologist, Orygen,The National Centre of Excellence in Youth Mental Health,Centre for Youth Mental Health,The University of Melbourne andSchool of Psychology,University of Waikato,Australia. 7. Research Fellow, School of Medicine and Public Health,University of Newcastle,Australia. 8. Associate Professor, School of Medicine and Public Health,University of Newcastle,Australia. 9. National Vocational Services Manager, Orygen,The National Centre of Excellence in Youth Mental Health, Australia. 10. Research Assistant, Monash University,Australia. 11. Associate Professor, Orygen,The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health,The University of Melbourne,Australia. 12. Professor, Orygen,The National Centre of Excellence in Youth Mental Health andCentre for Youth Mental Health,The University of Melbourne, Australia. 13. Professor, Orygen,The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health,The University of Melbourne,Australia.
Abstract
BACKGROUND: High unemployment is a hallmark of psychotic illness. Individual placement and support (IPS) may be effective at assisting the vocational recoveries of young people with first-episode psychosis (FEP).AimsTo examine the effectiveness of IPS at assisting young people with FEP to gain employment (Australian and Clinical Trials Registry ACTRN12608000094370). METHOD: Young people with FEP (n = 146) who were interested in vocational recovery were randomised using computer-generated random permuted blocks on a 1:1 ratio to: (a) 6 months of IPS in addition to treatment as usual (TAU) or (b) TAU alone. Assessments were conducted at baseline, 6 months (end of intervention), 12 months and 18 months post-baseline by research assistants who were masked to the treatment allocations. RESULTS: At the end of the intervention the IPS group had a significantly higher rate of having been employed (71.2%) than the TAU group (48.0%), odds ratio 3.40 (95% CI 1.17-9.91, z = 2.25, P = 0.025). However, this difference was not seen at 12- and 18-month follow-up points. There was no difference at any time point on educational outcomes. CONCLUSIONS: This is the largest trial to our knowledge on the effectiveness of IPS in FEP. The IPS group achieved a very high employment rate during the 6 months of the intervention. However, the advantage of IPS was not maintained in the long term. This seems to be related more to an unusually high rate of employment being achieved in the control group rather than a gross reduction in employment among the IPS group.Declaration of interestNone.
RCT Entities:
BACKGROUND: High unemployment is a hallmark of psychotic illness. Individual placement and support (IPS) may be effective at assisting the vocational recoveries of young people with first-episode psychosis (FEP).AimsTo examine the effectiveness of IPS at assisting young people with FEP to gain employment (Australian and Clinical Trials Registry ACTRN12608000094370). METHOD: Young people with FEP (n = 146) who were interested in vocational recovery were randomised using computer-generated random permuted blocks on a 1:1 ratio to: (a) 6 months of IPS in addition to treatment as usual (TAU) or (b) TAU alone. Assessments were conducted at baseline, 6 months (end of intervention), 12 months and 18 months post-baseline by research assistants who were masked to the treatment allocations. RESULTS: At the end of the intervention the IPS group had a significantly higher rate of having been employed (71.2%) than the TAU group (48.0%), odds ratio 3.40 (95% CI 1.17-9.91, z = 2.25, P = 0.025). However, this difference was not seen at 12- and 18-month follow-up points. There was no difference at any time point on educational outcomes. CONCLUSIONS: This is the largest trial to our knowledge on the effectiveness of IPS in FEP. The IPS group achieved a very high employment rate during the 6 months of the intervention. However, the advantage of IPS was not maintained in the long term. This seems to be related more to an unusually high rate of employment being achieved in the control group rather than a gross reduction in employment among the IPS group.Declaration of interestNone.
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