Reddy L Felice, Kern Robert S
Department of Veterans Affairs VISN22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA.
UCLA Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA.
Schizophr Res Cogn. 2014 Oct 12;1(3):144-148. doi: 10.1016/j.scog.2014.09.004. eCollection 2014 Sep.
Unemployment is a primary functional deficit for the majority of adults with schizophrenia. Research indicates that over two-thirds of adults living in the community with schizophrenia are unemployed. Despite effective programs to assist with job identification and placement, the ability to attain and maintain employment remains a pressing concern. Neurocognitive functioning is widely acknowledged to be a determinant of work outcome; however, effect sizes tend to be in the small to medium range. The present study sought to further understand the determinants of work outcome among a sample of 104 veterans with schizophrenia enrolled in a supported employment program. A small percentage of veterans in the study got competitive jobs; 53% who secured jobs maintained employment for longer than 6 months. Cognition, social cognition, and symptoms were unrelated to job attainment. However, speed of processing and social cognition were significant predictors of work outcomes such as wages and tenure. These findings suggest that cognitive abilities including processing speed and the ability to accurately interpret and respond to social cues are significant determinants of whether individuals with schizophrenia remain employed. The results are discussed in light of current available treatment options and domains to target in synergy with work rehabilitation efforts.
失业是大多数成年精神分裂症患者的主要功能缺陷。研究表明，在社区生活的成年精神分裂症患者中，超过三分之二处于失业状态。尽管有有效的项目来协助寻找工作和安排就业，但获得并维持工作的能力仍然是一个紧迫问题。神经认知功能被广泛认为是工作结果的一个决定因素；然而，效应大小往往处于小到中等范围。本研究旨在进一步了解104名参加支持性就业项目的精神分裂症退伍军人样本中工作结果的决定因素。研究中的一小部分退伍军人获得了有竞争力的工作；53%找到工作的人保持就业超过6个月。认知、社会认知和症状与获得工作无关。然而，处理速度和社会认知是工资和任期等工作结果的重要预测因素。这些发现表明，包括处理速度以及准确解读和回应社会线索的能力在内的认知能力，是精神分裂症患者能否继续就业的重要决定因素。结合当前可用的治疗选择以及与工作康复努力协同作用的目标领域对结果进行了讨论。
