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Soc Psychiatry Psychiatr Epidemiol. 2019 Aug 27. doi: 10.1007/s00127-019-01756-0. [Epub ahead of print]

The association between early-onset schizophrenia with employment, income, education, and cohabitation status: nationwide study with 35 years of follow-up.

Author information

1
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland. christian.hakulinen@helsinki.fi.
2
iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark. christian.hakulinen@helsinki.fi.
3
National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark. christian.hakulinen@helsinki.fi.
4
Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark. christian.hakulinen@helsinki.fi.
5
National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark.
6
Queensland Brain Institute, The University of Queensland, St Lucia, Australia.
7
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.
8
iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
9
Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark.
10
Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.

Abstract

PURPOSE:

Individuals with schizophrenia have been reported to have low employment rates. We examined the associations of schizophrenia with employment, income, and status of cohabitation from a work life course perspective.

METHODS:

Nationwide cohort study including all individuals (n = 2,390,127) born in Denmark between 1955 and 1991, who were alive at their 25th birthday. Diagnosis of schizophrenia (yes/no) between ages 15 and 25 was used as an exposure. Employment status, annual wage or self-employment earnings, level of education, and cohabitant status from the age of 25-61 (years 1980-2016) were used as outcomes.

RESULTS:

Schizophrenia diagnosis between ages 15 and 25 (n = 9448) was associated with higher odds of not being employed (at the age of 30: OR 39.4, 95% CI 36.5-42.6), having no secondary or higher education (7.4, 7.0-7.8), and living alone (7.6, 7.2-8.1). These odds ratios were two-to-three times lower and decreasing over time for those individuals who did not receive treatment in a psychiatric inpatient or outpatient clinic for schizophrenia after the age of 25. Between ages 25-61, individuals with schizophrenia have cumulative earning of $224,000, which is 14% of the amount that the individuals who have not been diagnosed with schizophrenia earn.

CONCLUSIONS:

Individuals with schizophrenia are at high risk of being outside the labour market and living alone throughout their entire life, resulting in an enormous societal loss in earnings. Individuals with less chronic course of schizophrenia had a gradual but substantial improvement throughout their work life.

KEYWORDS:

Prospective study; Psychosis; Register-based study; Socioeconomic outcomes

PMID:
31456027
DOI:
10.1007/s00127-019-01756-0

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