Employment and the associated impact on quality of life in people diagnosed with schizophrenia

Abstract

Clazien Bouwmans,1 Caroline de Sonneville,1 Cornelis L Mulder,2,3 Leona Hakkaart-van Roijen11Institute for Medical Technology Assessment, Erasmus University Rotterdam, 2Epidemiological and Social Psychiatric Research Institute, Erasmus Medical Center, 3Parnassia Psychiatric Institute, Rotterdam, the NetherlandsAbstract: A systematic review was conducted to assess the employment rate of people with schizophrenia. Additionally, information from the selected studies concerning factors associated with employment and health-related quality of life (HRQoL) was examined. Employment rates ranged from 4% to 50.4%. The studies differed considerably in design, patient settings, and methods of recruitment. The most frequently reported factors associated with employment were negative and cognitive symptoms, age of onset, and duration and course of the disease. Individual characteristics associated with unemployment were older age, lower education, and sex (female). Additionally, environmental factors, eg, the availability of welfare benefits and vocational support programs, seemed to play a role. Generally, being employed was positively associated with HRQoL. However, the causal direction of this association remained unclear, as studies on the bidirectional relationship between employment and HRQoL were lacking.Keywords: health-related quality of life, employment, work, unemployment, mental illness, patient characteristics, environment