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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 9/2012

01-09-2012 | Original Paper

The relationships between employment, clinical status, and psychiatric hospitalisation in patients with schizophrenia receiving either IPS or a conventional vocational rehabilitation programme

Authors: Reinhold Kilian, Christoph Lauber, Rana Kalkan, Wulf Dorn, Wulf Rössler, Durk Wiersma, Jooske T. van Buschbach, Angelo Fioritti, Toma Tomov, Jocelyn Catty, Tom Burns, Thomas Becker

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 9/2012

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Abstract

Purpose

Positive relationships between employment and clinical status have been found in several studies. However, an unequivocal interpretation of these relationships is difficult on the basis of common statistical methods.

Methods

In this analysis, a structural equation model approach for longitudinal data was applied to identify the direction of statistical relationships between hours worked, clinical status and days in psychiatric hospital in 312 persons with schizophrenia who participated in a multi-centre randomised controlled trial comparing the effectiveness of Individual Placement and Support (IPS) with conventional vocational services in six study settings across Europe. Data were analysed by an autoregressive cross-lagged effects model, an autoregressive cross-lagged model with random intercepts and an autoregressive latent trajectory model.

Results

Comparison of model fit parameters suggested the autoregressive cross-lagged effects model to be the best approach for the given data structure. All models indicated that patients who received an IPS intervention spent more hours in competitive employment and, due to indirect positive effects of employment on clinical status, spent fewer days in psychiatric hospitals than patients who received conventional vocational training.

Conclusions

Results support the hypothesis that the IPS intervention has positive effects not only on vocational but also on clinical outcomes in patients with schizophrenia.
Appendix
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Metadata
Title
The relationships between employment, clinical status, and psychiatric hospitalisation in patients with schizophrenia receiving either IPS or a conventional vocational rehabilitation programme
Authors
Reinhold Kilian
Christoph Lauber
Rana Kalkan
Wulf Dorn
Wulf Rössler
Durk Wiersma
Jooske T. van Buschbach
Angelo Fioritti
Toma Tomov
Jocelyn Catty
Tom Burns
Thomas Becker
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 9/2012
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-011-0451-z

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