{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:27:11Z","timestamp":1793572031218,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004737","name":"National Health Research Institutes","doi-asserted-by":"publisher","award":["CG-113-GP-01"],"award-info":[{"award-number":["CG-113-GP-01"]}],"id":[{"id":"10.13039\/501100004737","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004737","name":"National Health Research Institutes","doi-asserted-by":"publisher","award":["CG-114-GP-02"],"award-info":[{"award-number":["CG-114-GP-02"]}],"id":[{"id":"10.13039\/501100004737","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study examined employment trajectories following the diagnosis and antipsychotic treatment of schizophrenia, with particular focus on transitions to long-acting injectable antipsychotic treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a nationwide matched cohort study using Taiwan\u2019s National Health Insurance Research Database (2001\u20132021). Individuals aged 18\u201364\u2009years with newly diagnosed schizophrenia spectrum disorders were matched 1:1 with individuals without schizophrenia by birth year, sex, and index date. Employment trajectories were analyzed using controlled interrupted time-series models. To evaluate treatment-related transitions, individuals initiating long-acting injectable antipsychotics were compared with matched oral antipsychotic users. Subgroup analyses were conducted by illness duration and baseline medication adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The schizophrenia cohort (n\u2009=\u200993,041) showed substantially lower employment odds than matched comparisons (OR\u2009=\u20090.31), with a marked decline around diagnosis (OR\u2009=\u20090.90) and only modest recovery thereafter (post-diagnosis trend OR\u2009=\u20091.09 per year). In the treatment analysis (18,488 matched pairs), long-acting injectable users had lower baseline employment odds than oral antipsychotic users (OR\u2009=\u20090.85) and an immediate decline around long-acting injectable initiation (OR\u2009=\u20090.92), followed by a modestly more favorable post-initiation employment trend (OR\u2009=\u20091.03). More favorable post-initiation trends were observed among individuals with longer illness duration and lower baseline adherence. No meaningful differences in employment trajectories were observed across different long-acting injectable formulations, including flupentixol, risperidone, haloperidol, paliperidone, and fluphenazine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Employment outcomes in schizophrenia appear shaped by diagnostic and treatment-related transitions rather than static disease status. Stabilization after long-acting injectable initiation may be linked to incremental improvements in employment trajectories for some subgroups, but optimizing long-term vocational outcomes likely requires integrated psychosocial and vocational support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00048674261483942","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T07:46:42Z","timestamp":1789199202000},"page":"1099-1109","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Employment trajectories following the diagnosis and after long-acting injectable antipsychotic treatment in patients with schizophrenia: A nationwide study"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2762-7295","authenticated-orcid":false,"given":"Chi-Shin","family":"Wu","sequence":"first","affiliation":[{"name":"National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan"},{"name":"Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan"},{"name":"Department of Psychiatry, National Taiwan University Hospital, Douliu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-2698","authenticated-orcid":false,"given":"Shi-Heng","family":"Wang","sequence":"additional","affiliation":[{"name":"National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan"},{"name":"Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan"},{"name":"Department of Medical Research, China Medical University Hospital, China Medical University, Taichung"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5786-3366","authenticated-orcid":false,"given":"Wei-Lieh","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, National Taiwan University Hospital, Douliu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Shiang","family":"Wu","sequence":"additional","affiliation":[{"name":"National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan"},{"name":"Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2021.03.013"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00856"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2024.30.6.549"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.161"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.17006"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796023000562"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010802"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbm029"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2013.03.007"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.30773\/pi.2019.0087"},{"issue":"4","key":"e_1_3_2_12_1","first-page":"188","article-title":"Charlson comorbidity index: ICD-9 update and ICD-10 translation","volume":"12","author":"Glasheen WP","year":"2019","unstructured":"Glasheen WP, Cordier T, Gumpina R, et al. 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