Sumiyoshi Chika, Harvey Philip D, Takaki Manabu, Okahisa Yuko, Sato Taku, Sora Ichiro, Nuechterlein Keith H, Subotnik Kenneth L, Sumiyoshi Tomiki
Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan.
Department of Psychiatry School of Medicine, University of Miami Miller School of Medicine; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA.
Schizophr Res Cogn. 2015 Sep 9;2(3):105-112. doi: 10.1016/j.scog.2015.07.003. eCollection 2015 Sep.
Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.
精神分裂症患者的功能结局表明其认知、日常及社会功能得以恢复。具体而言，工作状态的改善被认为对他们的独立生活和自我效能最为重要。本研究的主要目的是：1）确定哪些结局因素可预测以工作时长量化的职业功能；2）为这些因素的量表提供临界值，以实现更好的工作状态。45名日本精神分裂症患者和111名健康对照者参与了本研究。认知、日常活动能力和社会功能分别通过日本版的MATRICS认知共识成套测验（MCCB）、加利福尼亚大学圣地亚哥分校基于表现的技能评估简表（UPSA-B）以及为MATRICS-PASS修改的社会功能量表个体版（MATRICS-PASS修改版SFS）进行评估。通过多元线性回归分析（直接预测工作时长）和多元逻辑回归分析（基于工作时长预测二分法工作状态）来估计工作结局的潜在因素。进行ROC曲线分析以确定区分良好和不良工作状态的临界点。结果表明，由视觉/言语学习和情绪管理组成的认知成分以及由独立生活和职业功能组成的社会功能成分是预测工作时长/状态的潜在因素。ROC分析中获得的临界点表明，这些因素测量指标上60%-70%的成就有望维持更好的工作状态。我们的研究结果表明，认知和社会功能特定方面的改善对精神分裂症患者的工作结局很重要。
