Singleness and unemployment increase the risk of schizophrenia. Schizophrenia
subsequently increases the risk of singleness and unemployment.
To describe long-term changes in marital status and labor market affiliation
before and after the first admission with schizophrenia.
A case-control study.
Setting and Participants
The sample included 5341 patients with a diagnosis of schizophrenia
at the first admission to a psychiatric facility between 1970 and 1999, and
53 410 matched control subjects. A person admitted in 1999 was followed up
in the registers from 1980 to 1997 (ie, from 19 to 2 years before admission).
Individuals admitted in 1970 could be followed up from 10 years until 27 years
Main Outcome Measures
Annual socioeconomic indicators.
Individuals who were later hospitalized were more frequently living
alone, unemployed, receiving social benefits, or otherwise outside the labor
market when compared with controls, as early as 19 years before their first
admission. For individuals with schizophrenia, the odds ratios of being unmarried
or not being fully employed were significantly increased even 25 years after
admission. This pattern was especially pronounced for men and for individuals
who had more admissions. The ratios increased until admission, with a steeper
increase in the years before admission. After admission, the odds declined
to the level shown before admission and then stabilized.
Schizophrenia hinders social achievement long before the first admission.
The first hospital episode is followed by a period during which social status
does not deteriorate further except for the transition into disability pension.