Abstract
Abstract
Background
Class and social disadvantage have long been identified as significant factors in the etiology and epidemiology of psychosis. Few studies have explicitly examined the impact of intersecting social disadvantage on long-term employment and financial independence.
Methods
We applied latent class analysis (LCA) to 20-year longitudinal data from participants with affective and non-affective psychosis (n = 256) within the Chicago Longitudinal Research. LCA groups were modeled using multiple indicators of pre-morbid disadvantage (parental social class, educational attainment, race, gender, and work and social functioning prior to psychosis onset). The comparative longitudinal work and financial functioning of LCA groups were then examined.
Results
We identified three distinct latent classes: one comprised entirely of White participants, with the highest parental class and highest levels of educational attainment; a second predominantly working-class group, with equal numbers of Black and White participants; and a third with the lowest parental social class, lowest levels of education and a mix of Black and White participants. The latter, our highest social disadvantage group experienced significantly poorer employment and financial outcomes at all time-points, controlling for diagnosis, symptoms, and hospitalizations prior to baseline. Contrary to our hypotheses, on most measures, the two less disadvantaged groups did not significantly differ from each other.
Conclusions
Our analyses add to a growing literature on the impact of multiple forms of social disadvantage on long-term functional trajectories, underscoring the importance of proactive attention to sociostructural disadvantage early in treatment, and the development and evaluation of interventions designed to mitigate ongoing social stratification.
Funder
National Institute of Mental Health
Foundation for Excellence in Mental Health Care
Publisher
Cambridge University Press (CUP)
Reference114 articles.
1. Uncovering recovery: The resistible rise of recovery and resilience;Harper;Studies in Social Justice,2012
2. How do macro-level structural determinants affect inequalities in mental health? – A systematic review of the literature;McAllister;International Journal for Equity in Health,2018
3. ‘Are these my thoughts?’: A 20-year prospective study of thought insertion, thought withdrawal, thought broadcasting, and their relationship to auditory verbal hallucinations;López-Silva;Schizophrenia Research,2022
4. Diagnostic and prognostic significance of Schneiderian first-rank symptoms: A 20-year longitudinal study of schizophrenia and bipolar disorder;Rosen;Comprehensive Psychiatry,2011
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