Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norway.
Psychiatry Res. 2011 Aug 15;188(3):334-42. doi: 10.1016/j.psychres.2011.04.021. Epub 2011 May 14.
Neurocognitive deficits are a core feature of schizophrenia that is associated with poor occupational functioning. Few studies have investigated this relationship in patients with first-episode psychosis. The current study examined the characteristics of employed and unemployed patients with first-episode psychosis at baseline and 2-year follow-up, and the predictive value of neurocognition on employment status. One-hundred and twenty-two first-episode psychosis patients were assessed with clinical and neurocognitive measures at baseline. Occupational status was assessed at baseline and 2-year follow-up. Those unemployed at baseline were rated lower on global functioning and were more likely to have a schizophrenia spectrum disorder. Total employment rates were 41% at baseline and 38% at 2-year follow-up. Four employment paths emerged at follow-up, defined as persistently employed, becoming unemployed, entering employment and persistently unemployed. The persistently employed group had the highest global functioning score. For the total sample, baseline employment status and sustained attention predicted employment status at follow-up. For those employed at baseline, better sustained attention, higher global functioning, more positive symptoms and less alcohol use predicted persistent employment at follow-up. For those unemployed at baseline, none of the variables predicted change in employment status. Implications of these results are discussed.
神经认知缺陷是精神分裂症的核心特征，与职业功能不良有关。很少有研究调查首发精神病患者的这种关系。本研究在基线和 2 年随访时检查了首发精神病患者中就业和失业患者的特征，以及神经认知对就业状况的预测价值。122 名首发精神病患者在基线时接受了临床和神经认知评估。职业状况在基线和 2 年随访时进行了评估。基线时失业的患者整体功能评分较低，更有可能患有精神分裂症谱系障碍。基线时的总就业率为 41%，2 年后为 38%。随访时出现了 4 种就业途径，分别为持续就业、失业、就业和持续失业。持续就业组的整体功能评分最高。对于整个样本，基线就业状况和持续注意力预测了随访时的就业状况。对于那些在基线时就业的人，更好的持续注意力、更高的整体功能、更少的阳性症状和更少的酒精使用预测了随访时的持续就业。对于那些在基线时失业的人，没有任何变量可以预测就业状况的变化。讨论了这些结果的意义。
