Initial and final work performance in schizophrenia: Cognitive and symptom predictors
Initial and final work performance in schizophrenia: Cognitive and symptom predictors
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DOI：
10.1097/00005053-200302000-00004
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发表时间：
2003-02-01
影响因子：
1.9
通讯作者：
Bell, MD
中科院分区：
文献类型：
--
作者：
Bryson, G;Bell, MD
研究表明，认知功能可能会限制精神分裂症患者的工作速度，任期和工作类型。本研究验证了这一假设，即在工作绩效的初始改善所需的认知能力将不同于在以后的职业发展所需的。96例参加工作康复计划的精神分裂症或情感障碍门诊患者在入院时进行神经心理学测试。每两周对他们的工作表现进行一次评估，持续26周。将认知测试变量输入回归，预测从第1周到第13周和第13周到第26周的个体性能曲线的斜率。神经心理学变量占28%的变化，在初始阶段的斜率。最强的预测因素是测量注意力不集中的持续表现任务变量。其他重要的变量是特质思维，认知灵活性和非文字记忆的措施。神经心理学变量占19%的变化，在最后一段时间的斜率。最强的预测因素是语言学习，而认知冲动和心理功能的测量也是重要的贡献者。在第1至13周或第13至26周，工作表现与症状之间没有关系。这些发现表明，虽然注意力对最初的成功更为重要，但言语记忆对持续改善更为重要。及时补救或适应这种缺陷可能是成功康复的必要特征。
Studies have shown that cognitive functioning may limit the rate, tenure, and type of work performed by people with schizophrenia. The present study tested the hypothesis that cognitive abilities needed for initial improvement in work performance would differ from those needed in later vocational development. Ninety-six outpatients with schizophrenia or schizoaffective disorder who participated in a work rehabilitation program were administered neuropsychological testing at intake. Their work performance was evaluated biweekly for 26 weeks. Cognitive test variables were entered into regressions predicting the slope of individual performance curves from weeks 1 to 13 and 13 to 26. Neuropsychological variables accounted for 28% of the variance in slope during the initial period. The strongest predictor was a Continuous Performance Task variable that measures inattentiveness. Other important variables were measures of idiosyncratic thinking, cognitive flexibility, and verbal memory. Neuropsychological variables accounted for 19% of the variance in the slope during the final period. The strongest predictor was verbal learning, while measures of cognitive impulsivity and psychomotor functioning were also significant contributors. There was no relationship between work performance and symptoms for weeks 1 to 13 or 13 to 26. These findings suggest that while attention is more important for initial success, verbal memory becomes more important for sustained improvement. Remediating or accommodating such deficits in a time-sensitive fashion may be a necessary feature for successful rehabilitation.