Time between schizophrenia onset and first request for disability status in France and associated patient characteristics.

Objective: This study examined a sample of French persons with schizophrenia to explore the occupational history between onset of illness and first request for disability status, the duration of this period, and the demographic and clinical characteristics associated with a long duration.

Methods: Persons with schizophrenia or schizoaffective disorder (N=110) requesting a disability allowance or the status of disabled worker for the first time were assessed by using a standardized questionnaire that collected information on clinical, occupational, and income history. Characteristics associated with a long duration were explored by using multivariate analyses.

Results: The majority of persons (92%) worked at least once during their lifetime, but this proportion fell dramatically to less than half after the onset of illness. Nearly half of the participants did not receive any income outside of financial support from the family after the onset of illness. The median delay between the onset of illness and the first request for disability status was four years. The characteristics independently predicting a long duration (that is, any time longer than the median, or four or more years) of the period between illness onset and first request were older age, higher educational level, a longer period of working after illness onset, and more than one psychiatric hospitalization.

Conclusions: Professionals who choose to delay requesting disability benefits for their clients in order to promote social rehabilitation may paradoxically exacerbate the social consequences of the disease because of clients' lack of resources. Future studies should further explore the implicit and explicit criteria used by mental health professionals and social workers in deciding whether a person with schizophrenia should request disability benefits.