Functioning, psychiatric symptoms and quality of life of individuals with severe mental disorders after psychiatric rehabilitation.

PURPOSE: Psychiatric disorders may have a negative effect on individuals' living, forming intimate relationships, education, and employment. The aim of psychiatric rehabilitation is to promote recovery - finding ways to cope with mental disorders despite debilitating symptoms. This study aimed to explore the outcomes of accommodation, social inclusion, psychiatric symptoms, substance and service use, quality of life and subjective recovery of young adults with severe mental illness after psychiatric rehabilitation. MATERIALS AND METHODS: The study population consisted of individuals who had been in residential psychiatric rehabilitation between the ages of 18-29 years. Data on outcomes were collected using a questionnaire after a flexible follow-up period (mean 29 months). The questionnaire was answered by 32 eligible persons. We analysed multiple outcomes and compared the proportion of persons living independently at the start, after psychiatric rehabilitation, and at the follow-up point. RESULTS: At the start of the rehabilitation, 33%, at the end, 69%, and at follow-up, 78% lived independently. However, most had not reached competitive employment nor were studying. Cognitive symptoms were the most common psychiatric symptoms, followed by depressive symptoms. More than 80% of the sample felt that they had partly recovered from their severe mental illness. CONCLUSION: According to the results of this study residential psychiatric rehabilitation may have positive effects on functioning and independent living at follow-up. Reaching competitive employment is difficult for persons with severe mental disorders and effective rehabilitation interventions need to be implemented. However, this study had limitations, and these results should be considered preliminary.

Effect of onset age on the long-term outcome of early-onset psychoses and other mental disorders: a register-based Northern Finland Birth Cohort 1986 study.

Psychiatric illnesses can affect the social transitions of adolescence and young adulthood, such as completing education and entering working life and relationships. However, associations between earlier onset age and long-term outcomes among those with early-onset psychoses (EOP) are unclear, as are the long-term outcomes of EOP compared to non-psychotic disorders. We used national register data of the Northern Finland Birth Cohort 1986 to detect persons with EOP and other early-onset psychiatric disorders. The long-term clinical and work-family outcomes of persons with onset age before 18 years (n = 41 psychoses, n = 495 non-psychoses) or between 18-22 years (n = 61 psychoses, n = 377 non-psychoses) were compared. Individuals with the onset of psychosis between 18-22 years had significantly more unfavourable long-term outcomes when compared to those with psychosis onset before 18 years. Persons with psychosis onset before the age of 18 years had similar outcomes to those with non-psychotic psychiatric disorder onset before 18 years regarding educational level, marital status, having children, and substance use disorders. Individuals with EOP were more often on a disability pension compared to those with other early-onset mental disorders. Adjusting for sex, educational level and substance use only slightly diluted these results. Unexpectedly, later onset age of EOP was associated with worse outcomes. Those with psychosis onset between 18-22 years of age are in a critical period, which underlines the importance of investing on interventions in this age group. Further studies on the effect of the onset age on later outcomes in EOP are needed.