Li Na, Ying Chen, Deng Hong
Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Shanghai Arch Psychiatry. 2012 Aug;24(4):222-30. doi: 10.3969/j.issn.1002-08329.2012.04.003.
Studies from other countries indicate that occupational skills training can improve the social functioning and the quality of life of patients with schizophrenia but there is little research about the relationship of occupational skills and the functional status of patients in China.
Use a translated Chinese version of the Comprehensive Occupational Therapy Evaluation scale to evaluate occupational functining in inpatients and recently discharged patients with schizophrenia and assess the relationship of occupational functioning to demographic, clinical and cognitive measures.
Thirty-five inpatiens and 29 recently discharged outpatients with schizophrenia were evaluated by trained clinicals using the COTE, the Positive and Negative Syndrome Scale (PANSS) and a neuropsychological battery that included the Wisconsin Card Sorting Test (WCST), the Continuous Perfomance Test (CPT), the digit symbol-coding subtest from the Wechsler Adult Intelligence Scale (WAIS), and Trail Making Test Parts A and B (TMT-A, TMT-B).
The total score on the COTE and the three COTE dimensional scores (evaluating general behavior, interpersonal communication and task behavior) were all strongly correlated with the PANSS total score and the PANSS positive symptom, negative symptom and general pathology subscale scores (ranked correlation coefficients range from 0.40 to 0.90). The correlationship of the COTE measures was significantly greater with the PANSS negative symptom score than with the PANSS positive symptom score. The COTE scores were also significantly correlated with the Continuous Performance Test measures, the WAIS digit symbol-coding test scores and some, but not all, of the measures derived from the TMT-A, the TMT-B, and the WCST. Mutiple regression analyses found that the four COTE measures of occupational functioning were most strongly associated with either the PANSS total score or the PANSS negative symptom score and secondarily associated with time to complete TMT-B, the CPT measure on number of omissions, and the respondent's years of education.
Occupational functioning measures of inpatients and recently discharged outpatients with schizophrenia are closely related to the severity of psychiatric symptoms and, to a lesser extent, with cognitive functioning measures and duration of education.
其他国家的研究表明，职业技能培训可以改善精神分裂症患者的社会功能和生活质量，但在中国，关于职业技能与患者功能状态之间关系的研究较少。
使用中文版的综合职业治疗评估量表来评估精神分裂症住院患者和近期出院患者的职业功能，并评估职业功能与人口统计学、临床和认知指标之间的关系。
35名精神分裂症住院患者和29名近期出院的门诊患者由经过培训的临床医生使用COTE、阳性和阴性症状量表（PANSS）以及一套神经心理测试进行评估，这套测试包括威斯康星卡片分类测验（WCST）、持续性操作测验（CPT）、韦氏成人智力量表（WAIS）中的数字符号编码分测验，以及连线测验A和B部分（TMT-A、TMT-B）。
COTE总分以及三个COTE维度得分（评估一般行为、人际沟通和任务行为）均与PANSS总分以及PANSS阳性症状、阴性症状和一般病理学子量表得分高度相关（等级相关系数范围为0.40至0.90）。COTE测量值与PANSS阴性症状得分的相关性显著高于与PANSS阳性症状得分的相关性。COTE得分也与持续性操作测验测量值、WAIS数字符号编码测验得分以及部分（但不是全部）来自TMT-A、TMT-B和WCST的测量值显著相关。多元回归分析发现，职业功能的四项COTE测量值与PANSS总分或PANSS阴性症状得分关联最为紧密，其次与完成TMT-B的时间、CPT遗漏数测量值以及受试者的受教育年限相关。
精神分裂症住院患者和近期出院门诊患者的职业功能测量值与精神症状的严重程度密切相关，在较小程度上与认知功能测量值和受教育时长相关。
