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Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders

Published online by Cambridge University Press:  23 March 2020

B. Karpov
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
G. Joffe
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
K. Aaltonen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
J. Suvisaari
Affiliation:
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271Helsinki, Finland
I. Baryshnikov
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
P. Näätänen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
M. Koivisto
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
T. Melartin
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
J. Oksanen
Affiliation:
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271Helsinki, Finland
K. Suominen
Affiliation:
Department of Social Services and Health Care, Nordenskiöldinkatu 20, 15-7, 00250Helsinki, Finland
M. Heikkinen
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland
E. Isometsä*
Affiliation:
Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014Helsinki, Finland National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, Mannerheimintie 166, 00271Helsinki, Finland
*
* Corresponding author at. Department of Psychiatry, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland. Fax: +358 9 471 63735. E-mail address:erkki.isometsa@hus.fi (E. Isometsä).
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Abstract

Background:

Major mental disorders are highly disabling conditions that result in substantial socioeconomic burden. Subjective and objective measures of functioning or ability to work, their concordance, or risk factors for them may differ between disorders.

Methods:

Self-reported level of functioning, perceived work ability, and current work status were evaluated among psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n = 113), bipolar disorder (BD, n = 99), or depressive disorder (DD, n = 188) within the Helsinki University Psychiatric Consortium Study. Correlates of functional impairment, subjective work disability, and occupational status were investigated using regression analysis.

Results:

DD patients reported the highest and SSA patients the lowest perceived functional impairment. Depressive symptoms in all diagnostic groups and anxiety in SSA and BD groups were significantly associated with disability. Only 5.3% of SSA patients versus 29.3% or 33.0% of BD or DD patients, respectively, were currently working. About half of all patients reported subjective work disability. Objective work status and perceived disability correlated strongly among BD and DD patients, but not among SSA patients. Work status was associated with number of hospitalizations, and perceived work disability with current depressive symptoms.

Conclusions:

Psychiatric care patients commonly end up outside the labour force. However, while among patients with mood disorders objective and subjective indicators of ability to work are largely concordant, among those with schizophrenia or schizoaffective disorder they are commonly contradictory. Among all groups, perceived functional impairment and work disability are coloured by current depressive symptoms, but objective work status reflects illness course, particularly preceding psychiatric hospitalizations.

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Type
Original article
Copyright
Copyright © European Psychiatric Association 2017

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