Most studies on predictors of vocational outcomes are cross-sectional and results are varied. This study aimed to examine the vocational rates of patients with first-episode psychosis (FEP), identify factors predicting a lack of engagement in age-appropriate roles, and evaluate the predictive ability of a model with baseline sociodemographic information and 2-year symptom and functioning trajectories on vocational outcomes. The Singapore Early Psychosis Intervention Program (EPIP) has maintained a standing database on patient clinico-demographic information. The primary outcome, vocational status, was operationalized as "meaningfully employed", that is, being gainfully employed or engaged in an age-appropriate role, and "unemployed". Using logistic regression, the predictive ability of the proposed model was evaluated. Vocational data was available for 1177 patients accepted into EPIP between 2001 and 2012. At the end of two years in the service, 829 (70.4%) patients were meaningfully employed and 348 (29.6%) patients were unemployed. The binary logistic regression model on the prediction of 2-year vocational outcomes yielded an AUC of 0.759 (SE = 0.016, p-value
This study describes the development and validation of Chinese, Malay and Tamil translations of the Positive Mental Health Instrument (PMHI) in a general population sample in Singapore. Translations were performed using two independent forward translations followed by expert panel discussions and tested for content, construct and language appropriateness using focus group discussions. The final translated tools were field-tested among 220 residents per language using self-administered questionnaires comprising the translated PMHI and other validity measures. Missing data, floor and ceiling effects, confirmatory factor analysis (CFA), internal consistency, item response theory differential item functioning (IRT-DIF) and criterion validity were assessed. A total of 10 PMHI-Chinese items, 26 PMHI-Malay items and six response categories and six PMHI-Tamil items were modified based on expert panel and focus group discussions. PMHI had low missing data and showed negative but acceptable skewness (<2) and kurtosis (<7) for all translations, except for the PMHI-Malay "spirituality" subscale (skewness: -2.8; kurtosis: 12.5). CFA showed that all three PMHI translations fulfilled the original six-factor-higher-order structure (RMSEA = 0.05, CFI = 0.962, TLI = 0.96). Cronbach's alpha coefficients for total PMHI were 0.958, 0.954, 0.945 and 0.949 in the overall sample and the Chinese, Malay and Tamil translations, respectively. The three translations of the PMHI showed expected and significant positive (r = 0.116 to 0.663) and negative correlations (r = -0.137 to -0.574) with established measures. The findings show that the Chinese, Malay and Tamil translations of the PMHI have high internal consistency and validity in this multi-ethnic population.