Occupational status and hospitalization for severe mental disorders: findings from Friuli Venezia Giulia region, Italy, 2008-2017

Purpose: to investigate to which extent occupational status (employed, unemployed, retired, economically inactive), and job titles in employed, were associated with types of hospitalizations and psychiatric diagnoses among inpatients of Friuli Venezia Giulia (FVG) Region, Italy. Methods: Observational study based on 10-years register data (2008 - 2017) on 2929 subjects hospitalized in General Hospital Psychiatric Units. Odds ratios (OR) of hospitalizations and psychiatric diagnoses for occupational status and job titles were calculated by logistic regression analysis. Results: Employed were at lower risk of urgent and involuntary hospitalization. The risk of urgent hospitalization was higher for affective, organic or other psychiatric disorders, while all psychiatric diagnoses were at lower risk of involuntary hospitalization than psychotic disorders. Using white collars as reference category in employed, police and military forces showed a significant higher risk for urgent hospitalization (OR = 2.3) and affective disorders (OR = 1.9). A higher risk for affective disorders was also found in managers (OR=2.0). Blue collars were at higher risk for alcohol and substance abuse (OR = 1.7). A decreasing number of ordinary and in involuntary hospitalizations was observed during the study period. Conclusions: Employment was protective for urgent and involuntary hospitalizations, and for severe diagnoses, as psychosis. Among employed, hospitalization for affective disorders was more likely in managers, army, as well as for substances abuse in blue collars. More research is needed to assess the association between specific occupational groups and involuntary hospitalization. Future research would benefit to distinct between temporary and permanent job position.