Evidence-based interventions for vocational recovery in first-episode psychosis: A meta-analysis of employment and education rates.
Oscar Gonzalo, Juan Luis Sánchez-González, Alba Sánchez-Gil et al.
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In 30 seconds
This PROSPERO-registered meta-analysis assessed whether evidence-based vocational interventions improve employment and education after first-episode psychosis. It included 31 studies (n = 8651) and used random-effects models to analyse employment, education, and combined vocational outcomes. Vocational interventions were associated with higher competitive employment than control conditions (odds ratio = 2.35, 95% CI 1.88-2.94); Individual Placement and Support also showed an association with improved employment (odds ratio = 2.86, 95% CI 1.81-4.54). No intervention showed a consistent advantage for education rates.
Key findings
- Vocational interventions were associated with higher competitive employment than control conditions (odds ratio = 2.35, 95% CI 1.88-2.94).
- Individual Placement and Support was associated with improved competitive employment (odds ratio = 2.86, 95% CI 1.81-4.54).
- No intervention showed a consistent advantage for education rates (odds ratio = 1.19, 95% CI 0.80-1.76).
- The combined vocational endpoint had substantial heterogeneity (I 2 = 69.6%, τ 2 = 0.296, p < 0.001) and possible publication bias.
Why it matters
Work and education are important recovery priorities for young people with first-episode psychosis. The findings suggest that structured vocational support may improve employment outcomes, while evidence for education outcomes is less consistent. Distinguishing these endpoints can help services interpret the evidence and consider vocational support in relation to patients’ employment goals.
What to keep in mind
The combined vocational endpoint showed substantial heterogeneity and possible publication bias, limiting its interpretability.