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Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 11, pp 1865–1871 | Cite as

Work functioning of schizophrenia patients in a rural south Indian community: status at 4-year follow-up

  • Kudumallige K. Suresh
  • Channaveerachari Naveen Kumar
  • Jagadisha Thirthalli
  • Somashekar Bijjal
  • Basappa K. Venkatesh
  • Udupi Arunachala
  • Kengeri V. Kishorekumar
  • Doddaballapura K. Subbakrishna
  • Bangalore N. Gangadhar
Original Paper

Abstract

Purpose

This report describes the work functioning of schizophrenia patients receiving antipsychotic treatment in a rural south Indian community and examines the factors associated with it.

Methods

We assessed work functioning of 201 patients who have completed a minimum of 3 years of follow-up as part of a cohort study of schizophrenia patients receiving community-based treatment. ‘Work’ section of the Indian disability evaluation and assessment scale (IDEAS) was used to evaluate work-related disability at the time of recruitment and after a mean (SD) 47.0 (9.6) months of follow-up. Patients with moderate to profound work-related disability were compared with those with no or mild disability across socio-demographic and clinical variables.

Results

75 (37.3 %) were agriculturists; 58 (28.9 %) were pursuing household jobs; 28 (13.9 %) were daily wage labourers; 7 (3.5 %) were skilled labourers; 7 (3.5 %) were involved in other jobs. 26 (12.9 %) were not doing any sort of work. The proportion of patients with moderate or profound disability reduced from 137/201 (68.2 %) at baseline to 82/201 (40.8 %) at follow-up (p < 0.001). Work-related disability reduced significantly [mean (SD) work score on IDEAS was 2.2 (1.6) at baseline and 1.1 (1.2) at follow-up; t = −9.1; p < 0.001]. Logistic regression analysis showed that work-related disability was significantly associated with male gender, longer duration of illness, higher psychopathology and poor treatment adherence.

Conclusion

Nearly two-thirds of schizophrenia patients living in this rural south Indian community had satisfactory work functioning, a rate, which is substantially higher than rates reported from high-income countries. Agrarian work atmosphere and rural sociocultural milieu may have contributed to this in our sample. However, substantial proportion of patients remains considerably disabled. This highlights the need for concerted, community-level efforts to improve their functioning.

Keywords

Work functioning Schizophrenia Disability Rural India 

Notes

Acknowledgments

This project was funded by National Mental Health Programme, Government of India’s research grants to BN Gangadhar (2005–2007). The authors gratefully acknowledge the immense dedication shown by Drs SM Guggali, MN Naveen and Ms KV Suma in coordinating the project work.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Kudumallige K. Suresh
    • 1
  • Channaveerachari Naveen Kumar
    • 1
  • Jagadisha Thirthalli
    • 1
  • Somashekar Bijjal
    • 1
  • Basappa K. Venkatesh
    • 2
  • Udupi Arunachala
    • 3
  • Kengeri V. Kishorekumar
    • 1
  • Doddaballapura K. Subbakrishna
    • 1
  • Bangalore N. Gangadhar
    • 1
  1. 1.National Institute of Mental Health and Neurosciences (NIMHANS)BangaloreIndia
  2. 2.Department of PsychiatryPenn State/Milton S. Hershey Medical CenterHersheyUSA
  3. 3.Manasa Nursing HomeThirthahalliIndia

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