Cognitive correlates of job tenure among patients with severe mental illness
Cognitive correlates of job tenure among patients with severe mental illness
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DOI：
10.1176/appi.ajp.159.8.1395
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发表时间：
2002-08-01
影响因子：
17.7
通讯作者：
Lehman, AF
中科院分区：
文献类型：
--
作者：
Gold, JM;Goldberg, RW;Lehman, AF
目的：有明确的证据表明，精神分裂症患者的认知表现与功能预后相关。然而，很少有研究专门研究竞争性就业绩效或职业康复的长期结果的认知相关性。本研究的目的是在对照临床试验的背景下，通过比较两种职业康复方法来检验职业功能的认知预测因素。方法：对150例进入职业康复试验的患者进行广泛的神经心理学测试。在24个月的随访期间评估职业表现。结果：在随访期间，40名获得竞争性就业的患者与110名未就业的患者在基线认知表现上没有差异。相反，多项认知测量与患者被雇佣的总小时数显著相关。认知与工作任期的关系似乎相当普遍，涉及智商、注意力、工作记忆和解决问题的能力。结论：在两种职业康复方法的临床试验中，认知表现是工作任期的显著预测因子，而不是工作成就的显著预测因子。看来，许多长期失业的病人能够通过有效的职业服务获得有竞争力的就业机会。然而，长期就业的成功可能与基线认知表现的多个方面有关。
Objective: There is clear evidence that cognitive performance is a correlate of functional outcome among patients with schizophrenia. However, few studies have specifically examined the cognitive correlates of competitive employment performance or the longer-term outcomes of vocational rehabilitation. The objective of the present study was to examine the cognitive predictors of vocational functioning in the context of a controlled clinical trial by comparing two approaches to vocational rehabilitation.Method: A broad neuropsychological battery was administered to 150 patients upon entry into the vocational rehabilitation trial. Vocational performance was assessed over a 24-month follow-up interval.Results: There were no differences in baseline cognitive performance between the 40 patients who obtained competitive employment and the 110 patients who remained unemployed over the follow-up interval. In contrast, multiple cognitive measures were significantly correlated with the total number of hours that patients were employed. The cognition-job tenure relationship appears to be fairly general, involving measures of IQ, attention, working memory, and problem solving.Conclusions: Cognitive performance was a significant predictor of job tenure but not job attainment in the context of a clinical trial of two vocational rehabilitation approaches. It appears that many persistently unemployed patients are capable of obtaining competitive employment with effective vocational services. Longer-term employment success, however, may be related to multiple aspects of baseline cognitive performance.