Fujino Haruo, Sumiyoshi Chika, Sumiyoshi Tomiki, Yasuda Yuka, Yamamori Hidenaga, Ohi Kazutaka, Fujimoto Michiko, Hashimoto Ryota, Takeda Masatoshi, Imura Osamu
Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Faculty of Human Development and Culture, Fukushima University, 1 Kanayagawa, Fukushima, Fukushima 960-1296, Japan.
Schizophr Res Cogn. 2015 Dec 7;3:20-25. doi: 10.1016/j.scog.2015.10.005. eCollection 2016 Mar.
Although impaired social functioning, particularly poor employment status, is a cardinal feature of patients with schizophrenia and leads to decreased quality of life (QOL), few studies have addressed the relationship between these two clinical issues. The aim of this study was to determine whether employment status predicts subjective QOL and to evaluate a model in which functional capacity mediates the relationship between general cognitive performance and employment status. Ninety-three patients with schizophrenia were administered a comprehensive battery of cognitive tests, the UCSD Performance-based Skills Assessment-Brief version (UPSA-B), the Social Functioning Scale (SFS), and the Subjective Quality of Life Scale (SQLS). First, we evaluated a model for predicting the employment/occupation subscale score of the SFS using path analysis, and the model fitted well ( (4) = 3.6, = 0.46; CFI = 1.0; RMSEA < 0.001, with 90% CIs: 0-0.152). Employment status was predicted by negative symptoms and functional capacity, which was in turn predicted by general cognitive performance. Second, we added subjective QOL to this model. In a final path model, QOL was predicted by negative symptoms and employment status. This model also satisfied good fit criteria ( (7) = 10.3, = 0.17; CFI = 0.987; RMSEA = 0.072, with 90% CIs: 0-0.159). The UPSA-B and SFS scores were moderately correlated with most measures of cognitive performance. These results support the notion that better employment status enhances subjective QOL in patients with schizophrenia.
尽管社交功能受损，尤其是就业状况不佳，是精神分裂症患者的一个主要特征，并导致生活质量（QOL）下降，但很少有研究探讨这两个临床问题之间的关系。本研究的目的是确定就业状况是否能预测主观生活质量，并评估一个功能能力在一般认知表现与就业状况之间的关系中起中介作用的模型。对93名精神分裂症患者进行了一系列全面的认知测试、加州大学圣地亚哥分校基于表现的技能评估简版（UPSA-B）、社会功能量表（SFS）和主观生活质量量表（SQLS）。首先，我们使用路径分析评估了一个预测SFS就业/职业子量表得分的模型，该模型拟合良好（χ²(4) = 3.6，p = 0.46；CFI = 1.0；RMSEA < 0.001，90%置信区间：0 - 0.152）。就业状况由阴性症状和功能能力预测，而功能能力又由一般认知表现预测。其次，我们在这个模型中加入了主观生活质量。在最终的路径模型中，生活质量由阴性症状和就业状况预测。该模型也满足良好的拟合标准（χ²(7) = 10.3，p = 0.17；CFI = 0.987；RMSEA = 0.072，90%置信区间：0 - 0.159）。UPSA-B和SFS得分与大多数认知表现指标中度相关。这些结果支持了更好的就业状况能提高精神分裂症患者主观生活质量这一观点。
