Employment in Personality Disorders and the Effectiveness of Individual Placement and Support: Outcomes from a Secondary
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Employment in Personality Disorders and the Effectiveness of Individual Placement and Support: Outcomes from a Secondary Data Analysis T. T. Juurlink1,2 · F. Lamers1,2 · H. J. F. van Marle1,2 · H. Michon3 · J. T. van Busschbach4 · A. T. F. Beekman1,2 · J. R. Anema5
© The Author(s) 2019
Abstract Purpose Personality disorders (PDs) are associated with severe functional impairment and subsequent high societal costs, increasing the need to improve occupational functioning in PD. Individual placement and support (IPS) is an effective, evidence-based method of supported employment, which so far has been tested in various mixed patient populations with severe mental illness (SMI, including PDs). However, the effectiveness of IPS for PDs per se remains uninvestigated. Methods Data from the SCION trial were used, including 31 SMI patients with PDs and 115 SMI patients with other primary diagnoses (primarily psychotic disorders). First, the interaction effect of diagnosis (PD vs other SMI) and intervention (IPS vs traditional vocational rehabilitation) was studied. Second, in the IPS condition, difference between diagnostic groups in time to first job was studied. Results We did not find evidence of a moderating effect of PD diagnosis on the primary effect of IPS (proportion who started in regular employment) (OR = 0.592, 95% CI 0.80–4.350, p = 0.606) after 30 months. Also, PD diagnosis did not moderate the effect of time until first job in IPS. Conclusions From the present explorative analysis we did not find evidence for a moderating effect of PD diagnosis on the effectiveness of IPS among PD participants. This indicates that IPS could be as effective in gaining employment in participants with PD as it is in participants with other SMI. Future studies, implementing larger numbers, should confirm whether IPS is equally effective in PDs and study whether augmentations or alterations to the standard IPS model might be beneficiary for PD. Keywords Personality disorder · Employment · Individual placement and support · Netherlands · Secondary analysis
Introduction
* T. T. Juurlink [email protected] 1
Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
2
GGZ inGeest Specialized Mental Health Care, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
3
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
4
University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, The Netherlands
5
Social Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
Personality disorders (PDs) are characterized by enduring dysfunctional patterns of cognition, affect regulation, interpersonal and self-functioning, and impulse control. These dysfunctional patterns are inflexible, pervasive across a broad range of personal and social situations and cause considerable personal distress [1]. PD
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