BJPsych Open (Jan 2025)
Lost and found: dynamics of relationship and employment status over time in people with affective and psychotic spectrum disorders
- 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
Affiliations
- Fanny Senner
- ORCiD
- Institute 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, Germany
- Lisa Kerkhoff
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Kristina Adorjan
- ORCiD
- Institute 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, Switzerland
- Michael Lauseker
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Germany
- Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Janos L. Kalman
- ORCiD
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Mojtaba Oraki Kohshour
- ORCiD
- Institute 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, Iran
- Sergi Papiol
- Institute 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, Germany
- Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Sabrina K. Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Eva C. Schulte
- ORCiD
- Institute 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, Germany
- Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Ion-George Anghelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute Berlin, Germany
- Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Germany
- Bernhardt T. Baune
- Department 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, Australia
- Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
- Nina Dalkner
- Division of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
- Detlef E. Dietrich
- AMEOS Clinical Center Hildesheim, Hildesheim, Germany Center for Systems Neuroscience (ZSN), Hannover, Germany Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School of Hannover, Germany
- Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Germany DZPG (German Center for Mental Health), partner site Tübingen, Tübingen, Germany
- Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, Germany
- Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany
- Fabian U. Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
- Jens Reimer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Eva Z. Reinighaus
- Division of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
- Max Schmauß
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, Germany
- Andrea Schmitt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, Brazil
- Simon Senner
- Center for Psychiatry Reichenau, Academic Hospital University of Konstanz, Germany
- Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Germany
- Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
- Alkomiet Hasan
- Department 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, Germany
- Peter Falkai
- Department 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, Germany
- Thomas G. Schulze
- Institute 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, USA
- Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Germany
- Sophie-Kathrin Greiner
- ORCiD
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, Germany
- DOI
- https://doi.org/10.1192/bjo.2024.816
- Journal volume & issue
-
Vol. 11
Abstract
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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