Cognitive and clinical predictors of success in vocational rehabilitation in schizophrenia
Cognitive and clinical predictors of success in vocational rehabilitation in schizophrenia
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DOI：
10.1016/j.schres.2004.01.011
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发表时间：
2004-10-01
影响因子：
4.5
通讯作者：
Tunis, S
中科院分区：
文献类型：
--
作者：
Evans, JD;Bond, GR;Tunis, S
精神分裂症患者的认知障碍似乎与社会问题解决、社会和职业功能以及社会心理技能习得有关。本研究考察了精神分裂症患者的认知功能以及临床症状与职业结果的关系。112名患有DSM-IV精神分裂症谱系诊断的参与者在参加了几个就业项目后接受了全面的神经精神病学评估。神经心理学评估测试了语言学习和记忆、注意力、信息处理速度和执行功能。采用阳性和阴性证候量表（PANSS）评价临床症状。职业结果在基线评估后4个月进行评估，包括就业结果（如收入）和工作行为量表（WBI）评估的工作绩效。消极症状、学习和记忆表现、处理速度和执行功能与工作时间、周数和工资有关。逐步多元回归分析发现，在基线临床和认知预测因子中，只有言语学习记忆和认知紊乱症状是4个月后工作行为的显著预测因子。学习和记忆是4个月时综合就业的唯一显著预测因子。这些结果表明，认知的特定方面可能对职业结果有一定的预测作用。(C) 2004 Elsevier B.V.版权所有
Cognitive impairments in schizophrenia appear to be associated with social problem solving, social and vocational functioning, and psychosocial skill acquisition. The present study examined the relationship of cognitive functioning, as well as clinical symptoms, to vocational outcomes among individuals with schizophrenia. One hundred and twelve participants with DSM-IV schizophrenia spectrum diagnoses underwent a comprehensive neuropsychiatric evaluation after enrolling in one of several employment programs. The neuropsychological evaluation examined verbal learning and memory, attention, speed of information processing, and executive functioning. Clinical symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS). Vocational outcomes were assessed 4 months after baseline assessment and included both measures of employment outcome (e.g., earnings) and of work performance as assessed by the Work Behavior Inventory (WBI). Negative symptoms, learning and memory performance, processing speed, and executive functioning were related to hours, weeks, and wages earned on the job. Stepwise multiple regression analyses found that among baseline clinical and cognitive predictors, only verbal learning and memory and cognitive disorganization symptoms were significant predictors of work behaviors 4 months later. Learning and memory were the only significant predictors of integrated employment at 4 months. These results suggest specific aspects of cognition may be modestly predictive of vocational outcomes. (C) 2004 Elsevier B.V. All rights reserved.