TY - JOUR
T1 - Moving from supported to independent living
T2 - what are the barriers and facilitators for individuals with psychosis?
AU - Poppe, Anika
AU - Tiles-Sar, Natalia
AU - Konings, Stefan R.A.
AU - Habtewold, Tesfa Dejenie
AU - Bruggeman, Richard
AU - Alizadeh, Behrooz Z.
AU - van der Meer, Lisette
AU - van Amelsvoort, Therese
AU - Bartels-Velthuis, Agna A.
AU - Cahn, Wiepke
AU - de Haan, Lieuwe
AU - Schirmbeck, Frederike
AU - Simons, Claudia J.P.
AU - van Os, Jim
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/7
Y1 - 2024/7
N2 - Purpose: Living independently, as opposed to in sheltered housing or with caregivers, is an important aim in the recovery of individuals with psychosis, but the transition to independence can be challenging. This study aims to investigate how individuals with psychosis move between living arrangements and to identify the barriers and facilitators of moving towards independence. Methods: The living arrangements of 1119 individuals with non-affective psychosis from the Genetic Risk and Outcome of Psychosis study were assessed at baseline, at three- and six-year follow-ups and further categorized as either supported (sheltered housing or with parents) or independent (single or with partner/family). We estimated the probabilities of transitioning between the living statuses and investigated the influence of demographic characteristics, symptomatology, cognition, social support, and premorbid social adjustment on transition using Markov chain modelling. Results: The majority of individuals living in supported housing remained there during the six-year follow-up period (~ 60%). The likelihood of moving from supported to independent living was twice as high for participants who were younger, five-to-six times higher for women, twice as high for individuals with better overall cognition, and five times higher for those with a course of low positive symptoms. Conclusion: This study highlights that a large group of individuals with psychosis in supported housing is unlikely to move to independent living. Older men with cognitive impairments and who show continuous severe positive symptoms are the least likely to move living independently. Tailored interventions for these at-risk individuals could increase their chances of moving to independent living.
AB - Purpose: Living independently, as opposed to in sheltered housing or with caregivers, is an important aim in the recovery of individuals with psychosis, but the transition to independence can be challenging. This study aims to investigate how individuals with psychosis move between living arrangements and to identify the barriers and facilitators of moving towards independence. Methods: The living arrangements of 1119 individuals with non-affective psychosis from the Genetic Risk and Outcome of Psychosis study were assessed at baseline, at three- and six-year follow-ups and further categorized as either supported (sheltered housing or with parents) or independent (single or with partner/family). We estimated the probabilities of transitioning between the living statuses and investigated the influence of demographic characteristics, symptomatology, cognition, social support, and premorbid social adjustment on transition using Markov chain modelling. Results: The majority of individuals living in supported housing remained there during the six-year follow-up period (~ 60%). The likelihood of moving from supported to independent living was twice as high for participants who were younger, five-to-six times higher for women, twice as high for individuals with better overall cognition, and five times higher for those with a course of low positive symptoms. Conclusion: This study highlights that a large group of individuals with psychosis in supported housing is unlikely to move to independent living. Older men with cognitive impairments and who show continuous severe positive symptoms are the least likely to move living independently. Tailored interventions for these at-risk individuals could increase their chances of moving to independent living.
KW - Functional recovery
KW - Markov chain modeling
KW - Schizophrenia
KW - Sheltered housing
KW - Supported housing
UR - http://www.scopus.com/inward/record.url?scp=85188243792&partnerID=8YFLogxK
U2 - 10.1007/s00127-023-02586-x
DO - 10.1007/s00127-023-02586-x
M3 - Article
C2 - 38189942
AN - SCOPUS:85188243792
SN - 0933-7954
VL - 59
SP - 1243
EP - 1254
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
IS - 7
ER -