Search

Background: Psychotic disorders are associated with high rates of sustained unemployment, however, little is known about the long-term employment outcome of people at ultra-high risk (UHR) of developing psychosis. We sought to investigate the long-term unemployment rate and baseline predictors of employment status at follow-up in a large UHR cohort.Method: 268 UHR patients recruited from the Personal Assessment and Crisis Evaluation clinic in Melbourne, Australia were followed-up over 2-14years after initial presentation to the service. Individuals in no form of employment or education were classed as unemployed. Logistic regression analyses were used to examine predictors of employment outcome.Results: A high rate of unemployment was present at follow-up in this UHR sample (23%). At baseline, those who were unemployed at follow-up had a longer duration of untreated illness, more severe negative symptoms, lower IQ, poorer social and occupational functioning and reported more childhood trauma than the employed group. At follow-up, unemployed individuals exhibited significantly more severe symptoms on all measures and were more likely to have been diagnosed with a mood, anxiety, psychotic or substance use disorder. Childhood trauma and the duration of untreated illness at baseline were significant independent predictors of employment status at follow-up in the multivariate analyses.Conclusions: Nearly a quarter of this UHR sample was unemployed at long-term follow-up. The duration of untreated illness and the effects of childhood trauma are potentially modifiable risk factors for long-term employment outcome in this group. Vocational support may be beneficial for many UHR patients presenting to services. [ABSTRACT FROM AUTHOR]

Abstract: Cannabis use has been associated with greater risk of developing psychotic-like experiences (PLEs) and psychosis. This paper aims to determine if different levels of cannabis (lifetime, regular, recent) exposure are associated with PLEs and specific PLE subscales among adolescents. Participants consisted of a community sample of 880 adolescents in Melbourne, Australia. Adolescents were administered the positive symptom scale of the Community Assessment of Psychic Experiences (CAPE) and measures of substance use and depression. Lifetime cannabis use and the frequency of cannabis use in the last year (recent use) were associated with PLEs, primarily the experience of auditory and visual hallucinations (perceptual abnormalities). Low levels of recent cannabis use were more strongly associated with PLEs than more frequent use. These findings indicate that different levels of cannabis exposure were differentially associated with PLEs and highlight the need for early detection and treatment strategies for PLEs and cannabis use in adolescents. [Copyright &y& Elsevier]