The relationship between unemployment and mental disorders has been a significant subject of study since at least the Industrial Revolution. However, most data show associations of unemployment and isolated mental disorders, and this study field has been neglected in the last years. Therefore, this narrative review aims to provide an updated overview of the association between unemployment and mental health in general as well as the most prevalent mental disorders. A literature search was conducted using PubMed with the initial search terms “unemployment” and “mental health”. The identified disorders were then used as search terms for a more in-depth search. Two raters screened abstracts and identified the literature containing relevant information. As a main result, it could be demonstrated that regardless of age and sex, there is still a broad association between unemployment and mental well-being in general (e.g., quality of life measure for example by the General Health Questionnaire), suicide attempts, suicide rates, as well as specific psychiatric disorders (substance use disorder, schizophrenia, depression, bipolar disorders, compulsive/obsessive disorders, eating disorders, specific personality disorders, intelligence disorders/impairment, and ADHD). The most significant association was found for affective disorders (depression) and substance use disorders. The association in general was particularly evident for long-term unemployment and mental disorders. Returning to work reduced the prevalence rates of mental disorders significantly. The literature review confirms the results of much older and disease centered studies that unemployment and mental disorders are associated with each other. The main conclusion is that early medical detection and intervention among the mentally ill are as crucial as labor market policy interventions to prevent, avoid, and reduce unemployment.

Es soll der Einfluss der (bereichsspezifischen) Selbstwirksamkeit auf den Behandlungserfolg zu 3 Katamnesezeitpunkten (t1 = 6, t2 = 12 und t3 = 24 Monate nach Therapieende) bei 3 Patientengruppen mit unterschiedlichem Schweregrad der Alkoholabhängigkeit untersucht werden. In die Analyse wurden 3 Gruppen alkoholabhängiger Patienten (n = 169) eingeschlossen, wovon sich 65 Patienten in einer ambulanten Entwöhnungsbehandlung, 51 in einer stationären Kurzzeittherapie und 53 in einer stationären Langzeittherapie befanden. Die Selbstwirksamkeit wurde mit der Alcohol Abstinence Self-Efficacy Scale (AASE) erfasst. Der Behandlungserfolg wurde anhand der totalen Abstinenz zum jeweiligen Katamnesezeitpunkt operationalisiert. Die AASE differenziert in jeder Patientengruppe und zu jedem Katamnesezeitpunkt zuverlässig zwischen abstinenten und nicht abstinenten Patienten. Abstinente Patienten weisen signifikant höhere Werte in beiden Subskalen Zuversicht und Verlangen auf. Der stärkste Zusammenhang zwischen AASE und Behandlungserfolg zu t3 konnte für die stationäre Kurzzeitgruppe gefunden werden. Die Bedeutung der Ergebnisse für die klinische Praxis wird diskutiert. This study examines the relationship between (alcohol specific) self-efficacy expectancies and abstinence from alcohol measured at 3 follow-ups (t1 = 6, t2 = 12 and t3 = 24 months after treatment) in 3 groups of patients with different severity levels of their alcohol dependency. N = 169 patients were included (n = 65 outpatient treatment, n = 51 inpatient short-term and n = 53 inpatient long-term treatment). Self-efficacy was measured using the Alcohol Abstinence Self-Efficacy Scale (AASE). Treatment outcome was defined as complete abstinence from alcohol at time of follow-ups. The AASE differentiates reliably between abstinent and non-abstinent patients in each treatment group at the 3 follow-ups. Abstinent patients had significant higher scores in both of the two subscales confidence and temptation. The strongest relationship between AASE and treatment outcome could be found for subjects in short-term inpatient treatment. The impact of the results for clinical practice is discussed.

Alcohol dependence is associated with deficits in decision making and increased impulsiveness. Therefore, we compared decision making in abstinent alcohol-dependent people (“abstainers”) and matched healthy individuals (“comparison group”) to determine whether impulsiveness or personality traits play a role in decision making. Abstainers (n = 40) were recruited from treatment facilities in and around Munich, Germany, and the comparison group (n = 40) through personal contacts and social media. We assessed decision making with the Iowa Gambling Task (IGT), impulsiveness with the Barratt Impulsiveness Scale (BIS-11) and personality traits with the NEO Five-Factor Inventory (NEO-FFI). The comparison group performed significantly better in the IGT (mean profit € 159.50, SD 977.92) than the abstainers (mean loss - € 1,400.13, SD 1,362.10; p < .001) and showed significantly less impulsiveness in the BIS-11 (comparison group: mean 56.03, SD 7.80; abstainers: mean 63.55, SD 11.47; p < .001). None of the five personality traits assessed with the NEO-FFI differed significantly between the groups. The results confirm that abstinent alcohol-dependent people do not perform as well as healthy individuals in decision-making tasks and show greater impulsiveness, but in this study did not affect their decision-making ability.