Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Vocational rehabilitation for adults with psychotic disorders in a Scandinavian welfare society

Authors: Erik Falkum, Ole Klungsøyr, June Ullevoldsæter Lystad, Helen Christine Bull, Stig Evensen, Egil W. Martinsen, Svein Friis, Torill Ueland

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

This study examined the outcomes of a vocational rehabilitation program (The Job Management Program, JUMP) for persons with psychotic disorders based on close collaboration between health and welfare services.

Methods

Participants (N = 148) with broad schizophrenia spectrum disorders (age 18–65) were recruited from six counties in Norway. Three counties were randomized to vocational rehabilitation augmented with cognitive behaviour therapy (CBT), while the remaining three counties were randomized to vocational rehabilitation augmented with cognitive remediation (CR). This paper compares the vocational activity of the total group of JUMP participants with a treatment as usual group (N = 341), and further examines differences between the two JUMP interventions. Employment status (working/not working) was registered at the time of inclusion and at the end of the intervention period.

Results

The total number of JUMP participants in any kind of vocational activity increased from 17 to 77% during the intervention. Of these, 8% had competitive employment, 36% had work placements in ordinary workplaces with social security benefits as their income, and 33% had sheltered work. The total number of working participants in the TAU group increased from 15.5 to 18.2%. The JUMP group showed significant improvements of positive (t = −2.33, p = 0.02) and general (t = −2.75, p = 0.007) symptoms of psychosis. Significant differences between the CBT and CR interventions were not demonstrated.

Conclusions

The study supports existing evidence that the majority of persons with broad schizophrenia spectrum disorders can cope with some kind of work, given that internal and external barriers are reduced. Those who wish to work should be offered vocational rehabilitation.

Trial registration

ClinicalTrials.gov Identifier: NCT01139502. Registered on 6 February 2010.
Appendix
Available only for authorised users
Literature
1.
Jonsdottir A, Waghorn G. Psychiatric disorders and labour force activity. Ment Health Rev J. 2015;20(1):13.CrossRef
2.
3.
4.
Evensen S, Wisloff T, Lystad JU, Bull H, Ueland T, Falkum E. Prevalence, Employment Rate, and Cost of Schizophrenia in a High-Income Welfare Society: A Population-Based Study Using Comprehensive Health and Welfare Registers. Schizophr Bull. 2015. doi:10.​1093/​schbul/​sbv141.
5.
Helle S, Gråwe R. Sysselsetting og trygd blant personer med schizofrenidiagnose. Tidsskrift for Norsk Psykologforening. 2007;48(8):733-8.
6.
Melle I, Friis S, Hauff E, Vaglum P. Social functioning of patients with schizophrenia in high-income welfare societies. Psychiatr Serv. 2000;51(2):223–8.CrossRefPubMed
7.
Tandberg M, Sundet K, Andreassen OA, Melle I, Ueland T. Occupational functioning, symptoms and neurocognition in patients with psychotic disorders: investigating subgroups based on social security status. Soc Psychiatry Psychiatr Epidem. 2012;48(6):863-74.
8.
Evensen S, Ueland T, Lystad JU, Bull H, Klungsøyr O, Martinsen EW, Falkum E. Employment outcome and predictors of competitive employment at 2-year follow-up of a vocational rehabilitation programme for individuals with schizophrenia in a high-income welfare society. Nordic J Psychiatry. 2016;1–8. doi:10.​1080/​08039488.​2016.​1247195.
9.
OECD. Mental Health and Work. Norway: OECD Publishing; 2013.
10.
Spjelkavik Ø. Supported Employment in Norway and in the other Nordic countries. J Vocat Rehabil. 2012;37(3):163–72.
11.
12.
13.
Burns T, Catty J, White S, Becker T, Koletsi M, Fioritti A, for the EQOLISE Group. The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support. Schizophr Bull. 2009;35(5):949–58. doi:10.​1093/​schbul/​sbn024.CrossRefPubMed
14.
15.
16.
Bouwmans C, de Sonneville C, Mulder CL, Hakkaart-van Roijen L. Employment and the associated impact on quality of life in people diagnosed with schizophrenia. Neuropsychiatr Dis Treat. 2015;11:2125–42. doi:10.​2147/​ndt.​s83546.PubMedPubMedCentral
17.
Sensky T, Turkington D, Kingdon D, Scott JL, Scott J, Siddle R, Barnes TR. A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Arch Gen Psychiatry. 2000;57(2):165–72.CrossRefPubMed
18.
Warman DM, Grant P, Sullivan K, Caroff S, Beck AT. Individual and group cognitive-behavioral therapy for psychotic disorders: a pilot investigation. J Psychiatr Pract. 2005;11(1):27–34.CrossRefPubMed
19.
20.
21.
22.
Lysaker PH, Louanne WD, Nicole LH, Michael AN, Amanda W. Personal Narratives In Schizophrenia: Increases In Coherence Following 5 Months Of Vocational Rehabilitation. Psychiatr Rehabil J. 2005;29(1):66.CrossRefPubMed
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
Andersen TM, Holmström B, Honkapohja S, Korkman S, Tson SH, Vartainen J. The Nordic Model: Embracing Globalization and Sharing Risks. Helsinki: The Research Institute of Finnish Economy (ETLA); 2007.
33.
Bond GR, Drake RE, Becker DR. Generalizability of the Individual Placement and Support (IPS) model of supported employment outside the US World Psychiatry. February. 2012;11(1):32–9.
34.
Bond GR, Drake RE, Campbell K. Effectiveness of individual placement and support supported employment for young adults. Early Interv Psychiatry. 2014. doi:10.​1111/​eip.​12175.
35.
McFarlane WR. Multifamily groups in the treatment of severe psychiatric disorders. New York: Guilford Press; 2004.
36.
Wing JK, Curtis RH, Beevor AS. HoNOS: Health of the Nation Outcome Scales: Report on Research and Development July 1993-December 1995. London: Royal College of Psychiatrists; 1996.
37.
Harsvik T, Opdahl Mo T, Steihaug S. Jobbmestrende oppfølging, Andre delrapport SINTEF Helse (Vol. Januar 2008). Oslo: SINTEF; 2008.
38.
39.
Leff J, Vaughn C. Expressed emotion in families: Its significance for mental illness. New York: Guilford Press; 1984.
40.
Brager-Larsen L, Sundet KS, Engvik H, Ørbeck B, Nes RB. Psychometric properties of a Norwegian research version of "Wechsler Abbreviated Scale of Intelligence" (WASI); 2001.
41.
Wechsler D. Wechsler Abbreviated Scale of Intelligence. New York, NY: The Psychological Corporation: Harcourt Brace & Company; 1999.
42.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33. quiz 34–57.PubMed
43.
First MB, Spitzer RL, Gibbon M, Williams JB, Davies M, Borus J, Rounsaville B. The structured clinical interview for DSM-III-R personality disorders (SCID-II). Part II: Multi-site test-retest reliability study. J Personal Disord. 1995;9(2):92–104.CrossRef
44.
Kranzler HR, Kadden RM, Babor TF, Rounsaville BJ. Longitudinal, expert, all data procedure for psychiatric diagnosis in patients with psychoactive substance use disorders. J Nerv Ment Dis. 1994;182(5):277–83.CrossRefPubMed
45.
Spitzer RL. Psychiatric-Diagnosis - Are Clinicians Still Necessary. Compr Psychiatry. 1983;24:399–411.CrossRefPubMed
46.
Kay S, Opler L, Fiszbein A. Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS). New York: Albert Einstein College of Medicine; 1988.
47.
WHO. (2011). World Health Organization: WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD index 2011
48.
Mueser K, Drake RC, Clarke RE, McHugo GJ, Mercer-McFadden C, Ackerson TH. Toolkit on Evaluating Substance Abuse in Persons with Severe Mental Illness. Cambridge MA: Human Services Research Institute; 1995.
49.
IBM. IBM SPSS Statistics for Windows, Version 20.0. Armonk: IBM Corp; 2011.
50.
51.
Cook JR, Stefanski LA. Simulation-extrapolation estimation in parametric measurement error models. J Am Stat Assoc. 1994;89(428):1314–28.CrossRef
52.
Lederer W, Küchenhoff H, Lederer MW, Küchenhoff M. Package ‘simex’. 2009.
53.
Kukla M, Bond GR. A randomized controlled trial of evidence-based supported employment: Nonvocational outcomes. J Vocat Rehabil. 2013;38(2):91–8.
54.
Steen AH, Legard S, Jessen JE, Niels A, GMP. Samfunnsøkonomisk analyse av økt sysselsetting av personer med nedsatt funksjonsevne. AFI-rapport (Vol. 2012:5). Oslo: Arbeidsforskningsinstituttet; 2012.
55.
Steihaug S, Lippestad JW, Brattlid I. Evaluering av Jobbmestrende oppfølging: Arbeidsrehabilitering for personer med psykoselidelser. The Norwegian Directorate of Health SINTEF; 2013.
56.
Metadata
Title
Vocational rehabilitation for adults with psychotic disorders in a Scandinavian welfare society
Authors
Erik Falkum
Ole Klungsøyr
June Ullevoldsæter Lystad
Helen Christine Bull
Stig Evensen
Egil W. Martinsen
Svein Friis
Torill Ueland
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-1183-0

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Research article

Assessment of the burden on caregivers of patients with mental disorders in Jeddah, Saudi Arabia

Research article

Clinicians’ adherence to clinical practice guidelines for cardiac function monitoring during antipsychotic treatment: a retrospective report on 434 patients with severe mental illness

Research article

Polypharmacy among children and adolescents with psychiatric disorders in a mental referral hospital in Botswana

Research article

Adolescent substance use behavior and suicidal behavior for boys and girls: a cross-sectional study by latent analysis approach

Research article

Readiness to change and therapy outcomes of an innovative psychotherapy program for surgical patients: results from a randomized controlled trial

Research article

Perceptions of problem-drinker patients’ family members about their own hazardous-drinking behaviours in Chinese general hospitals: a qualitative study