Evans Jovier D, Bond Gary R, Meyer Piper S, Kim Hea Won, Lysaker Paul H, Gibson P Joseph, Tunis Sandra
Department of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), LD 124, 402 N. Blackford Street, Indianapolis, IN 46202-3275, USA.
Schizophr Res. 2004 Oct 1;70(2-3):331-42. doi: 10.1016/j.schres.2004.01.011.
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.
精神分裂症的认知障碍似乎与社会问题解决、社会及职业功能以及心理社会技能习得有关。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局之间的关系。112名被诊断为DSM-IV精神分裂症谱系障碍的参与者在参加了多个就业项目中的一个后，接受了全面的神经精神评估。神经心理学评估考察了言语学习与记忆、注意力、信息处理速度和执行功能。临床症状用阳性和阴性症状量表（PANSS）进行评估。在基线评估4个月后评估职业结局，包括就业结局指标（如收入）以及工作行为量表（WBI）评估的工作表现。阴性症状、学习与记忆表现、处理速度和执行功能与工作时长、工作周数及工作所得工资相关。逐步多元回归分析发现，在基线临床和认知预测因素中，只有言语学习与记忆以及认知紊乱症状是4个月后工作行为的显著预测因素。学习与记忆是4个月时综合就业的唯一显著预测因素。这些结果表明，认知的特定方面可能对职业结局有一定的预测作用。
