BIOLOGICAL AND PSYCHOSOCIAL PREDICTORS OF JOB-PERFORMANCE FOLLOWING AFIRST EPISODE OF PSYCHOSIS

Objective: The purposes of this study were 1) to evaluate occupational functioning 18 months after a first episode of psychosis and 2) to de termine Predictors of differential outcome. Method: Using a variety of sociodemographic, clinical, and psychophysiological measures, the pro ject team assessed adults experiencing a first episode of schizophreni a (N=33) or affective psychosis (N=31). identical measures were obtain ed from a comparison group (N=46) who had no history of psychiatric di sorder. Work performance was rated at entry into the study and 18 mont hs later. Results: At entry into the study, the schizophrenic subjects displayed the worst job performance, the asymptomatic individuals the best. The subjects with affective psychosis fell in between. Each of the two diagnostic groups evidenced postmorbid occupational decline. T hree factors predicted good outcome in the schizophrenic group-good pr emorbid job performance, female gender, and scores on Putative markers of biological vulnerability for the illness. For the affective disord er group, Positive labeling by a significant other proved the only pre dictor of good outcome. Conclusions: These findings suggest that postm orbid occupational decline is common to both schizophrenia and affecti ve psychosis. Past accomplishment and biological vulnerability predict ed short-term course for these schizophrenic patients; psychosocial fa ctors played a more Prominent role in affective psychosis.