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Determinants of Employment Outcome for the People with Schizophrenia Using the WHODAS 2.0

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Abstract

Purpose Since the vocational outcomes of people with schizophrenia should be viewed in a holistic way, the second edition of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) might provide an evaluation regarding employment potential. To determine whether the WHODAS 2.0 scores can be used to predict employment status, we examined the probabilistic cut-off values of the scores and analyzed the relationship between work status and demographic characteristics. Methods We selected 31,793 people aged between 18 and 65 with schizophrenia or schizoaffective disorder from the disability evaluation database in Taiwan and separated them into two groups based on employment status (employed and unemployed). We used logistic regression to explore the association between employment and demographic characteristics. Moreover, we conducted a receiver operating characteristic (ROC) analysis to determine the cut-off point to assist in determining employment potential based on the WHODAS 2.0 score. Results Among the 31,793 participants, 3367 were employed and 18,801 were unemployed. The unemployed participants accounted for a higher percentage of disability in each domain of the WHODAS. The ROC analysis revealed that the optimal cut-off point of the WHODAS score to distinguish the people who were employed and unemployed was 25.78 (area under curve = 0.80). Conclusions The present study indicated that work status can be determined by the total score across the six domains of the WHODAS score. Furthermore, the probability of employment may be determined initially by the cut-off point of the WHODAS score in order to economize evaluation time and prepare prevocational training for those with scores above 25.78.

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Acknowledgements

The research is funded by the Ministry of Science and Technology of Taiwan (MOST 106-2511-S-002-016-MY2). The authors would like to thank Dr. Ben-Shang Chang, Dr. Ting-Fang Wu, and Kai-Hsiang Chuang for providing technical consultation and help throughout the study.

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Authors and Affiliations

  1. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Shu-Jen Lu & Ay-Woan Pan

  2. Vocational Rehabilitation Resource Center for Individuals with Disabilities, Taoyuan, Taiwan

    Shu-Jen Lu

  3. Department of Psychiatry, Taipei Tzu Chi Hospital, New Taipei City, Taiwan

    Shu-Jen Lu

  4. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan

    Tsan-Hon Liou

  5. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Tsan-Hon Liou

  6. Department of Public Health, Tzu Chi University, Hualien, Taiwan

    Chia-Feng Yen

  7. Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan

    Feng-Hang Chang

  8. Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan

    Yen-Ling Chen

  9. Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA

    Reuben Escorpizo

  10. Swiss Paraplegic Research, Nottwil, Switzerland

    Reuben Escorpizo

  11. Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign, University of Illinois, Champaign, IL, USA

    David R. Strauser

  12. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan

    Ay-Woan Pan

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  1. Shu-Jen Lu
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Correspondence to Ay-Woan Pan.

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Lu, SJ., Liou, TH., Yen, CF. et al. Determinants of Employment Outcome for the People with Schizophrenia Using the WHODAS 2.0. J Occup Rehabil 29, 375–383 (2019). https://doi.org/10.1007/s10926-018-9794-6

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