Bell M D, Bryson G
Rehabilitation Research and Development Service, Department of Veterans Affairs, New Haven, Connecticut 06516, USA. bell.morris_d+@west-haven.va.gov
Schizophr Bull. 2001;27(2):269-79. doi: 10.1093/oxfordjournals.schbul.a006873.
Cognitive impairments may be an important contributor to disability in schizophrenia and may limit the rate of improvement in work rehabilitation. Thirty-three outpatients with schizophrenia or schizoaffective disorder who participated in a 6-month work rehabilitation program were assessed for symptom severity and administered neuropsychological testing at intake. Their work performance was evaluated biweekly using the Work Behavior Inventory. On each of five domains of work performance, 76 to 91 percent of subjects reached proficiency or improved significantly over 26 weeks. Individual differences in rate of improvement were robustly predicted by neuropsychological variables: Work Habits, r2 = 0.79; Personal Presentation, r2 = 0.73; Cooperativeness, r2 = 0.67; Work Quality, r2 = 0.56; Social Skills, r2 = 0.27; Total, r2 = 0.44. Neuropsychological measures had differential relationships to work domains. Individual differences in improvement were not predicted by symptom measures. These findings link cognitive impairment to disability and suggest that remediating or accommodating such deficits may be necessary for successful rehabilitation.
认知障碍可能是导致精神分裂症患者残疾的一个重要因素，并且可能会限制工作康复的改善速度。对33名参与了为期6个月工作康复项目的精神分裂症或分裂情感性障碍门诊患者，在入组时评估了症状严重程度并进行了神经心理学测试。使用工作行为量表每两周对他们的工作表现进行一次评估。在工作表现的五个领域中，76%至91%的受试者在26周内达到熟练水平或有显著改善。神经心理学变量能有力地预测改善速度的个体差异：工作习惯，r2 = 0.79；个人表现，r2 = 0.73；合作性，r2 = 0.67；工作质量，r2 = 0.56；社交技能，r2 = 0.27；总体，r2 = 0.44。神经心理学测量与工作领域的关系存在差异。症状测量无法预测改善的个体差异。这些发现将认知障碍与残疾联系起来，并表明纠正或适应这些缺陷可能是成功康复所必需的。
