Cognitive functioning and employment in severe mental illness
Cognitive functioning and employment in severe mental illness
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DOI：
10.1097/01.nmd.0000100921.31489.5a
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发表时间：
2003-12-01
影响因子：
1.9
通讯作者：
Mueser, KT
中科院分区：
文献类型：
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作者：
McGurk, SR;Mueser, KT
本研究比较了失业，支持就业，独立就业的严重精神疾病的客户的认知功能和行为学。失业的客户谁想要工作（N = 21）进行了比较，在支持就业计划（N = 17）和客户谁已经独立工作了至少1年（N = 23）的神经心理电池和积极和消极的综合征量表。失业的客户有更严重的症状和更差的认知功能的积极和消极的症状，几乎所有领域的认知功能。支持就业的客户有更严重的精神病症状和更差的工作记忆比独立就业的客户，但没有不同的阴性症状或其他领域的认知功能，包括注意力/浓度，心理速度，语言学习和记忆，或执行功能。最后，工作的复杂性与执行功能受损的独立工作的客户端之间，但不支持就业。严重的症状和认知障碍可能会干扰一些严重精神疾病患者获得竞争性工作的能力。支持就业方案似乎通过帮助客户补偿有问题的症状和认知障碍，并在较小程度上，通过寻找或开发环境利基，这些障碍不会妨碍他们执行必要的工作任务的能力。
This study compared cognitive functioning and symptomatology of unemployed, supported employed, and independently employed clients with severe mental illness. Unemployed clients who wanted to work (N = 21) were compared with clients working in supported employment programs (N = 17) and clients who had been working independently for at least 1 year (N = 23) on a neuropsychological battery and the Positive and Negative Syndrome Scale. Clients who were unemployed had more severe symptoms and worse cognitive functioning on both positive and negative symptoms, and almost all domains of cognitive functioning. Supported employed clients had more severe psychotic symptoms and worse working memory than independently employed clients, but did not differ in negative symptoms or the other domains of cognitive functioning, including attention/concentration, psychomotor speed, verbal learning and memory, or executive functions. Finally, job complexity was correlated with impaired executive functions among clients working independently, but not in supported employment. Severe symptoms and cognitive impairment may interfere with the ability of some clients with severe mental illness to obtain competitive work. Supported employment programs appear to work by helping clients compensate for problematic symptoms and cognitive impairment and, to a lesser extent, by finding or developing environmental niches in which these impairments do not impede their ability to perform the necessary job tasks.