Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders
Background Employment and relationship are crucial for social integration. However, individuals with major psychiatric disorders often face challenges in these domains. Aims We investigated employment and relationship status changes among patients across the affective and psychotic spectrum – in co...
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| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424008160/type/journal_article |
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| author | Fanny Senner Lisa Kerkhoff Kristina Adorjan Michael Lauseker Monika Budde Maria Heilbronner Janos L. Kalman Mojtaba Oraki Kohshour Sergi Papiol Daniela Reich-Erkelenz Sabrina K. Schaupp Eva C. Schulte Thomas Vogl Ion-George Anghelescu Volker Arolt Bernhardt T. Baune Udo Dannlowski Nina Dalkner Detlef E. Dietrich Andreas J. Fallgatter Christian Figge Carsten Konrad Fabian U. Lang Jens Reimer Eva Z. Reinighaus Max Schmauß Andrea Schmitt Simon Senner Carsten Spitzer Jörg Zimmermann Alkomiet Hasan Peter Falkai Thomas G. Schulze Urs Heilbronner Sophie-Kathrin Greiner |
| author_facet | Fanny Senner Lisa Kerkhoff Kristina Adorjan Michael Lauseker Monika Budde Maria Heilbronner Janos L. Kalman Mojtaba Oraki Kohshour Sergi Papiol Daniela Reich-Erkelenz Sabrina K. Schaupp Eva C. Schulte Thomas Vogl Ion-George Anghelescu Volker Arolt Bernhardt T. Baune Udo Dannlowski Nina Dalkner Detlef E. Dietrich Andreas J. Fallgatter Christian Figge Carsten Konrad Fabian U. Lang Jens Reimer Eva Z. Reinighaus Max Schmauß Andrea Schmitt Simon Senner Carsten Spitzer Jörg Zimmermann Alkomiet Hasan Peter Falkai Thomas G. Schulze Urs Heilbronner Sophie-Kathrin Greiner |
| author_sort | Fanny Senner |
| collection | DOAJ |
| description | Background
Employment and relationship are crucial for social integration. However, individuals with major psychiatric disorders often face challenges in these domains.
Aims
We investigated employment and relationship status changes among patients across the affective and psychotic spectrum – in comparison with healthy controls, examining whether diagnostic groups or functional levels influence these transitions.
Method
The sample from the longitudinal multicentric PsyCourse Study comprised 1260 patients with affective and psychotic spectrum disorders and 441 controls (mean age ± s.d., 39.91 ± 12.65 years; 48.9% female). Multistate models (Markov) were used to analyse transitions in employment and relationship status, focusing on transition intensities. Analyses contained multiple multistate models adjusted for age, gender, job or partner, diagnostic group and Global Assessment of Functioning (GAF) in different combinations to analyse the impact of the covariates on the hazard ratio of changing employment or relationship status.
Results
The clinical group had a higher hazard ratio of losing partner (hazard ratio 1.46, P < 0.001) and job (hazard ratio 4.18, P < 0.001) than the control group (corrected for age/gender). Compared with controls, clinical groups had a higher hazard of losing partner (affective group, hazard ratio 2.69, P = 0.003; psychotic group, hazard ratio 3.06, P = 0.001) and job (affective group, hazard ratio 3.43, P < 0.001; psychotic group, hazard ratio 4.11, P < 0.001). Adjusting for GAF, the hazard ratio of losing partner and job decreased in both clinical groups compared with controls.
Conclusion
Patients face an increased hazard of job loss and relationship dissolution compared with healthy controls, and this is partially conditioned by the diagnosis and functional level. These findings underscore a high demand for destigmatisation and support for individuals in managing their functional limitations.
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| format | Article |
| id | doaj-art-6d2ad091face45e493326801459fc981 |
| institution | Kabale University |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-6d2ad091face45e493326801459fc9812025-01-16T21:50:24ZengCambridge University PressBJPsych Open2056-47242025-01-011110.1192/bjo.2024.816Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disordersFanny Senner0https://orcid.org/0000-0003-3375-5314Lisa Kerkhoff1Kristina Adorjan2https://orcid.org/0000-0001-7501-9556Michael Lauseker3Monika Budde4Maria Heilbronner5Janos L. Kalman6https://orcid.org/0000-0003-0930-4214Mojtaba Oraki Kohshour7https://orcid.org/0000-0002-1357-2636Sergi Papiol8Daniela Reich-Erkelenz9Sabrina K. Schaupp10Eva C. Schulte11https://orcid.org/0000-0003-3105-5672Thomas Vogl12Ion-George Anghelescu13Volker Arolt14Bernhardt T. Baune15Udo Dannlowski16Nina Dalkner17Detlef E. Dietrich18Andreas J. Fallgatter19Christian Figge20Carsten Konrad21Fabian U. Lang22Jens Reimer23Eva Z. Reinighaus24Max Schmauß25Andrea Schmitt26Simon Senner27Carsten Spitzer28Jörg Zimmermann29Alkomiet Hasan30Peter Falkai31Thomas G. Schulze32Urs Heilbronner33Sophie-Kathrin Greiner34https://orcid.org/0000-0003-3607-1217Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Centres for Psychiatry Suedwuerttemberg, Ravensburg, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany University Hospital of Psychiatry and Psychotherapy, University of Bern, SwitzerlandInstitute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Max Planck Institute of Psychiatry, Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Department of Psychiatry and Psychotherapy, University Hospital Bonn, Faculty of Medicine, University of Bonn, Germany Institute of Human Genetics, University Hospital Bonn, Faculty of Medicine, University of Bonn, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyDepartment of Psychiatry and Psychotherapy, Mental Health Institute Berlin, GermanyInstitute for Translational Psychiatry, University of Münster, GermanyDepartment of Psychiatry, University of Münster, Germany Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, AustraliaInstitute for Translational Psychiatry, University of Münster, GermanyDivision of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, AustriaAMEOS Clinical Center Hildesheim, Hildesheim, Germany Center for Systems Neuroscience (ZSN), Hannover, Germany Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School of Hannover, GermanyDepartment of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Germany DZPG (German Center for Mental Health), partner site Tübingen, Tübingen, GermanyKarl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, GermanyDepartment of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, GermanyDepartment of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, GermanyDepartment of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDivision of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, AustriaDepartment of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, GermanyDepartment of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, BrazilCenter for Psychiatry Reichenau, Academic Hospital University of Konstanz, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, GermanyPsychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, GermanyDepartment of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, DZPG (German Center for Mental Health), partner site München/Augsburg, Eschwege, GermanyDepartment of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, DZPG (German Center for Mental Health), partner site München/Augsburg, Eschwege, GermanyInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, DZPG (German Center for Mental Health), partner site München/Augsburg, Eschwege, Germany Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, USA Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USAInstitute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, GermanyDepartment of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, GermanyBackground Employment and relationship are crucial for social integration. However, individuals with major psychiatric disorders often face challenges in these domains. Aims We investigated employment and relationship status changes among patients across the affective and psychotic spectrum – in comparison with healthy controls, examining whether diagnostic groups or functional levels influence these transitions. Method The sample from the longitudinal multicentric PsyCourse Study comprised 1260 patients with affective and psychotic spectrum disorders and 441 controls (mean age ± s.d., 39.91 ± 12.65 years; 48.9% female). Multistate models (Markov) were used to analyse transitions in employment and relationship status, focusing on transition intensities. Analyses contained multiple multistate models adjusted for age, gender, job or partner, diagnostic group and Global Assessment of Functioning (GAF) in different combinations to analyse the impact of the covariates on the hazard ratio of changing employment or relationship status. Results The clinical group had a higher hazard ratio of losing partner (hazard ratio 1.46, P < 0.001) and job (hazard ratio 4.18, P < 0.001) than the control group (corrected for age/gender). Compared with controls, clinical groups had a higher hazard of losing partner (affective group, hazard ratio 2.69, P = 0.003; psychotic group, hazard ratio 3.06, P = 0.001) and job (affective group, hazard ratio 3.43, P < 0.001; psychotic group, hazard ratio 4.11, P < 0.001). Adjusting for GAF, the hazard ratio of losing partner and job decreased in both clinical groups compared with controls. Conclusion Patients face an increased hazard of job loss and relationship dissolution compared with healthy controls, and this is partially conditioned by the diagnosis and functional level. These findings underscore a high demand for destigmatisation and support for individuals in managing their functional limitations. https://www.cambridge.org/core/product/identifier/S2056472424008160/type/journal_articleSocial integrationaffectivepsychoticfunctional leveldestigmatisation |
| spellingShingle | Fanny Senner Lisa Kerkhoff Kristina Adorjan Michael Lauseker Monika Budde Maria Heilbronner Janos L. Kalman Mojtaba Oraki Kohshour Sergi Papiol Daniela Reich-Erkelenz Sabrina K. Schaupp Eva C. Schulte Thomas Vogl Ion-George Anghelescu Volker Arolt Bernhardt T. Baune Udo Dannlowski Nina Dalkner Detlef E. Dietrich Andreas J. Fallgatter Christian Figge Carsten Konrad Fabian U. Lang Jens Reimer Eva Z. Reinighaus Max Schmauß Andrea Schmitt Simon Senner Carsten Spitzer Jörg Zimmermann Alkomiet Hasan Peter Falkai Thomas G. Schulze Urs Heilbronner Sophie-Kathrin Greiner Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders BJPsych Open Social integration affective psychotic functional level destigmatisation |
| title | Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders |
| title_full | Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders |
| title_fullStr | Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders |
| title_full_unstemmed | Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders |
| title_short | Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders |
| title_sort | lost and found dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders |
| topic | Social integration affective psychotic functional level destigmatisation |
| url | https://www.cambridge.org/core/product/identifier/S2056472424008160/type/journal_article |
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