WORK-ENVIRONMENT AND SCHIZOPHRENIA - AN EXTENSION OF THE AROUSAL HYPOTHESIS TO OCCUPATIONAL SELF-SELECTION

The present study investigated a possible mechanism underlying the occ upational self-selection of future schizophrenic patients prior to the ir first admission. More precisely, we explored whether schizophrenic patients are more likely than other psychotic patients to work in envi ronments with a low potential for arousal (low complexity environments ) in the last full-time job that preceded their hospitalization. All f irst admissions with psychotic symptoms to 15 hospitals providing inpa tient psychiatric services in the Baltimore-Washington area were surve yed during a 6-year period. Patients diagnosed with schizophrenia were compared to patients diagnosed with bipolar disorder and other psycho tic disorders to evaluate the suspected association. Study participant s were assessed with a modified version of the Diagnostic Interview Sc hedule. Standard survey questions were used to assess occupational bac kground. A measure based on the dictionary of occupational titles (DOT ) was used to estimate the degree of complexity to which patients had been exposed in their last full-time occupation. Data were analyzed us ing multinomial logistic regression. After adjustment for age, gender, marital status, unemployment, socioeconomic status, hospital type, an d physical demands and hazards on the job, patients with schizophrenia were more likely to have been working in low complexity environments in their last full-time jobs (e.g., janitors, gardeners, guards) than patients with bipolar disorder or with other psychotic disorders. Alte rnative explanations and potential implications regarding which work e nvironments might be best suited to the social behavior of patients wi th schizophrenia are examined.