Employment in Personality Disorders and the Effectiveness of Individual Placement and Support: Outcomes from a Secondary Data Analysis.
T T Juurlink, F Lamers, H J F van Marle and 4 others
PMID 31820219WHAT IT FOUND
Individual Placement and Support did not work significantly less well for participants with personality disorders than for those with other severe mental illnesses.
However, employment rates were numerically lower in the personality disorder group, and the study was too small to rule out a real difference.
Key findings
01A personality disorder diagnosis did not significantly modify the effectiveness of Individual Placement and Support on gaining employment.
02After 30 months, fewer participants with personality disorders in Individual Placement and Support found competitive employment compared to those with other severe mental illnesses, but the difference was not statistically significant.
03The study had low statistical power, meaning the lack of significant differences may be due to the small sample size rather than true equivalence.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was underpowered, with a small number of participants with personality disorders (n=31), making it difficult to detect real differences. Personality disorder diagnoses were based on clinical records rather than standardized assessments, which may affect accuracy. The sample lacked representation of all PD subtypes (e.g., only one participant with paranoid PD and none with schizotypal PD), limiting generalizability. Severity of personality disorder symptoms was not assessed, so it is unclear how symptom intensity influenced employment outcomes. Data on hours and days worked were missing, preventing a more detailed analysis of employment quality.
Declared interests
The paper does not explicitly state funding sources or conflicts of interest in the provided text.
The easy way to misread this
Do not conclude that IPS works equally well for people with personality disorders as it does for others. The study was too small to detect a difference, and the numerical trend showed lower employment rates for the personality disorder group. This is an absence of evidence for a difference, not evidence of equivalence.