Twamley Elizabeth W, Narvaez Jenille M, Sadek Joseph R, Jeste Dilip V, Grant Igor, Heaton Robert K
University of California, San Diego, Department of Psychiatry, San Diego, California 92103, USA.
J Nerv Ment Dis. 2006 Apr;194(4):268-74. doi: 10.1097/01.nmd.0000207362.84045.1b.
Schizophrenia and human immunodeficiency virus (HIV) infection both are associated with high rates of neurocognitive impairment. These impairments predict unemployment in both disorders, independent of other disease-related factors that may affect employment. In this study, we investigated work-related abilities and previous employment patterns in 27 unemployed patients with schizophrenia, 27 demographically matched unemployed HIV-infected participants, and 27 nonmatched employed HIV seropositive (HIV+) participants. All subjects were administered a computerized and hands-on assessment of vocational abilities and a comprehensive work history interview. Compared with the employed HIV+ group, the two unemployed groups had lower estimates of maximal lifetime job functioning. In terms of current vocational abilities, the employed HIV+ subjects generally performed best, followed by the unemployed HIV+ subjects and the patients with schizophrenia. Although the unemployed schizophrenia subjects had the most decline in vocational abilities (from estimated lifetime maximum level), the patterns of decline were similar in the two unemployed groups and were suggestive of parallel impairments in frontal-subcortical functioning.
精神分裂症和人类免疫缺陷病毒(HIV)感染均与高比率的神经认知障碍相关。这些障碍在这两种病症中均预示着失业,独立于其他可能影响就业的疾病相关因素。在本研究中,我们调查了27名失业的精神分裂症患者、27名人口统计学匹配的失业HIV感染参与者以及27名不匹配的就业HIV血清阳性(HIV+)参与者的工作相关能力和既往就业模式。所有受试者均接受了职业能力的计算机化及实际操作评估以及全面的工作经历访谈。与就业的HIV+组相比,两个失业组对最大终身工作功能的估计较低。就当前职业能力而言,就业的HIV+受试者总体表现最佳,其次是失业的HIV+受试者和精神分裂症患者。尽管失业的精神分裂症受试者职业能力下降最多(相对于估计的终身最高水平),但两个失业组的下降模式相似,提示额叶-皮质下功能存在平行损害。