Does socioeconomic status predict course and outcome in patients with psychosis?
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© Steinkopff Verlag 2001
ORIGINAL PAPER
Chiara Samele · Jim van Os · Kwame McKenzie · Andrew Wright · Catherine Gilvarry · Catherine Manley · Theresa Tattan · Robin Murray · On behalf of the UK700 Group
Does socioeconomic status predict course and outcome in patients with psychosis? Accepted: 3 August 2001
Chiara Samele, MSc PhD () · Kwame McKenzie MRCPsych · Catherine Gilvarry, BSc BA · Robin Murray (Head of Division) Division of Psychological Medicine Institute of Psychiatry De Crespigny Park London SE5 8AF, UK Tel.: +44-0 20/78 48 03 51 Fax: +44-0 20/77 01 90 44 E-Mail: [email protected] www.iop.kcl.ac.uk Cath Manley, BSc MA Department of Public Mental Health Imperial College School of Medicine at St Mary’s Paterson Centre 20 South Wharf Road London W2 1PD, UK Jim van Os, MSc PhD Department of Psychiatry and Neuropsychology Section of Social Psychiatry and Psychiatric Epidemiology Maastricht University PO BOX 616 6200 MD Maastricht, The Netherlands Andrew Wright, MSc Clinical Pharmacology Data Sciences Glaxo Wellcome R&D Greenford Road Greenford, Middlesex UB6 0HE, UK Theresa Tattan, MRCPsych School of Psychiatry and Behavioural Sciences Rawnsley Building Manchester Royal Infirmary Oxford Road Manchester M13 9WL, UK
■ Key words Socioeconomic status – Course and outcome – Severe mental illness – Psychosis – Clinical and social variables
Introduction There is a strong inverse association between socioeconomic status (SES) and the prevalence of schizophrenia
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UK700 Group Manchester Royal Infirmary – Tom Butler, Francis Creed, Janella Fraser, Peter Huxley, Nick Tarrier, Theresa Tattan. King’s College and Maudsley Hospitals, London – Tom Fahy, Catherine Gilvarry, Kwame McKenzie, Robin Murray, Jim van Os, Elizabeth Walsh. St Mary’s and St Charles’ Hospitals, London – John Green, Anna Higgit, Elizabeth van Horn, Donal Leddy, Catherine Manley, Patricia Thornton, Peter Tyrer. St George’s Hospital, London – Rob Bale, Tom Burns, Matthew Fiander, Kate Harvey, Andy Kent, Chiara Samele. Health Economics Centre, York – Sara Byford, David Torgerson, Ken Wright. Statistical Centre, London – Simon Thompson, Ian White.
■ Abstract Background We examined the relationship between socioeconomic status (SES) and course and outcome of patients with psychosis. Two hypotheses were examined: a) patients with higher best-ever SES will have better course and outcome than those with lower best-ever SES, and b) patients with greater downward drift in SES will have poorer course and outcome than those with less downward drift. Method Data were drawn from the baseline and 2-year follow-up assessments of the UK700 Case Management Trial of 708 patients with severe psychosis. The indicators of SES used were occupational status and educational achievement. Drift in SES was defined as change from best-ever occupation to occupation at baseline. Results For the baseline data highly significant differences were found between best-ever groups and negative symptoms (non-manual vs. unemployed – coef –10.5, p=0.000, 95 % CIs 5.1–15.8), f
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