Sherry Kit Wa Chan1, Herbert H Pang2, Kang K Yan3, Christy Lai Ming Hui4, Yi Nam Suen5, Wing Chung Chang6, Edwin Ho Ming Lee7, Pak Sham8, Eric Yu Hai Chen9. 1. Clinical Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong. 2. Assistant Professor, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. 3. PhD student, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. 4. Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. 5. Research Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. 6. Clinical Associate Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong. 7. Clinical Assistant Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. 8. Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong. 9. Clinical Professor, Department of Psychiatry, Li Ka Shing Faculty of Medicine, and The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
Abstract
BACKGROUND: Little is known about long-term employment outcomes for patients with first-episode schizophrenia-spectrum (FES) disorders who received early intervention services. AIMS: We compared the 10-year employment trajectory of patients with FES who received early intervention services with those who received standard care. Factors differentiating the employment trajectories were explored. METHOD: Patients with FES (N = 145) who received early intervention services in Hong Kong between 1 July 2001 and 30 June 2002 were matched with those who entered standard care 1 year previously. We used hierarchical clustering analysis to explore the 10-year employment clusters for both groups. We used the mixed model test to compare cluster memberships and piecewise regression analysis to compare the employment trajectories of the two groups. RESULTS: There were significantly more patients who received the early intervention service in the good employment cluster (early intervention: N = 98 [67.6%]; standard care: N = 76 [52.4%]; P = 0.009). In the poor employment cluster, there was a significant difference in the longitudinal pattern between early intervention and standard care for years 1-5 (P < 0.0001). The number of relapses during the first 3 years, months of full-time employment during the first year and years of education were significant in differentiating the clusters of the early intervention group. CONCLUSIONS: Results suggest there was an overall long-term benefit of early intervention services on employment. However, the benefit was not sustained for all patients. Personalisation of the duration of the early intervention service with a focus on relapse prevention and early vocational reintegration should be considered for service enhancement.
BACKGROUND: Little is known about long-term employment outcomes for patients with first-episode schizophrenia-spectrum (FES) disorders who received early intervention services. AIMS: We compared the 10-year employment trajectory of patients with FES who received early intervention services with those who received standard care. Factors differentiating the employment trajectories were explored. METHOD:Patients with FES (N = 145) who received early intervention services in Hong Kong between 1 July 2001 and 30 June 2002 were matched with those who entered standard care 1 year previously. We used hierarchical clustering analysis to explore the 10-year employment clusters for both groups. We used the mixed model test to compare cluster memberships and piecewise regression analysis to compare the employment trajectories of the two groups. RESULTS: There were significantly more patients who received the early intervention service in the good employment cluster (early intervention: N = 98 [67.6%]; standard care: N = 76 [52.4%]; P = 0.009). In the poor employment cluster, there was a significant difference in the longitudinal pattern between early intervention and standard care for years 1-5 (P < 0.0001). The number of relapses during the first 3 years, months of full-time employment during the first year and years of education were significant in differentiating the clusters of the early intervention group. CONCLUSIONS: Results suggest there was an overall long-term benefit of early intervention services on employment. However, the benefit was not sustained for all patients. Personalisation of the duration of the early intervention service with a focus on relapse prevention and early vocational reintegration should be considered for service enhancement.
Entities:
Keywords:
Schizophrenia; cluster analysis; early intervention; employment; long-term outcomes
Authors: Sherry Kit Wa Chan; Hei Yan Veronica Chan; William G Honer; Tarun Bastiampillai; Yi Nam Suen; Wai Song Yeung; Ming Lam; Wing King Lee; Roger Man King Ng; Christy Lai Ming Hui; Wing Chung Chang; Edwin Ho Ming Lee; Eric Yu Hai Chen Journal: Schizophr Bull Date: 2021-03-16 Impact factor: 9.306
Authors: Zhisong Zhang; Kaising Sun; Chonnakarn Jatchavala; John Koh; Yimian Chia; Jessica Bose; Zhimeng Li; Wanqiu Tan; Sizhe Wang; Wenjing Chu; Jiayun Wang; Bach Tran; Roger Ho Journal: Int J Environ Res Public Health Date: 2019-12-31 Impact factor: 3.390