Vocational Pathways in First Episode Psychosis

By

ABSTRACT

Background: Psychotic disorders first emerge in late adolescence and early adulthood. This disorder disrupts the educational and vocational trajectories of young people. After recognizing this, adequate assistance is given to patients are suffering from FEP i.e. First Episode Psychosis. The proper assistance is provided so that those patients return to work and can be prevented from academic or employment loss.

Aims: Aspire of this research study is to comprehend the reason why patients who are suffering from FEP lose their jobs and how they get recuperation of it.

Method: Literature was searched by using MEDLINE, PsychINFO and Web of Knowledge. A retrospective analysis of 2 year routinely information which was collected on First Episode Psychosis cohort augmented with a qualitative analysis of their vocational experiences.

Results: Vocational outcome in First Episode Psychosis is allied with duration of untreated psychosis, social withdrawal, cognition, substance misuse and negative symptoms. Particularly, ethnicities, academic performance loss in adolescent and immediate verbal memory are linked to vocational loss in First Episode Psychosis, as well as, quality of life and level of social contact are also affected.

Subtle inception of psychosis, socioeconomic status, number of hospitalisations, gender and education level are linked with job or education recovery. Also allied with recuperation of vocation in First Episode Psychosis are stigma, treatment, alcohol use, academic premorbid adjustment, self esteem and difficulties identifying and achieving desired goals.

The proposed study will identify points in the trajectory of psychosis development when vocations are lost. The study will also identify patients' explanations for their vocational outcomes; aspirations and supports they received during this disorder.

Conclusion: In answering the main aim, this study will explain the pathway of vocational loss and the reason that why people recuperate from those losses and also suggest how existing interventions might be better used to protect against loss and promote recuperation.

TABLE OF CONTENTS

ABSTRACTii

CHAPTER 1: INTRODUCTION1

Introduction1

Background of the study1

Research Aims and Objectives4

Research aim4

Research objectives4

Research questions5

Dissertation Overview5

CHAPTER 2: LITERATURE REVIEW7

Introduction7

Aims of the review7

Methods7

Illness descriptor7

Vocational outcome descriptors8

Results10

Types of study found11

Main findings12

Discussion15

Factors associated with vocational status before emergence of psychotic illness16

Socioeconomic status and demographics16

Cognition17

Symptom and Duration of Untreated Psychosis (DUP)18

Factors associated with vocational status after the emergence of psychotic illness18

Cognition18

Duration of untreated psychosis (DUP)20

Symptoms and Diagnosis20

Demographics24

FEP patients attribute their vocational outcome to26

CHAPTER 3: METHODOLOGY28

Introduction28

Research questions28

Research Methodology28

Work Package 128

Work Package 2 (WP2): Qualitative Study on Patients' explanations/attributions of their vocational outcomes29

Research tools30

Care Programme Approach Common Assessment Tool (CPA)30

Brief Psychiatric Rating Scale (BPRS-18)30

Care Pathway Assessment Tool (HONOS)30

Data analysis31

Analysis of WP131

Analysis of WP231

Research limitations32

Knowledge gaps identified and implications for further research32

Ethical issues33

REFERENCE34

CHAPTER 1: INTRODUCTION

Introduction

In this chapter, the introduction of the study will be discussed. This chapter includes the aims and objectives and overall section summary.

Background of the study

The aspiration of adolescent is to attain the pertinent and career oriented job and progress in their lives but these aspirations are not fulfilled among those people who suffer from first psychotic episode (FEP). The onset of FEP subsequently leads to social exclusion; and decline in social ...