Karambelas George J, Allott Kelly A, Killackey Eóin, Farhall John, Cotton Sue M
Orygen, the National Centre of Excellence in Youth Mental Health.
School of Psychology and Public Health, La Trobe University.
Psychiatr Rehabil J. 2018 Dec;41(4):319-327. doi: 10.1037/prj0000317. Epub 2018 Sep 17.
Increased employment duration has been associated with change in performance on specific neurocognitive domains in populations with schizophrenia, but not in first-episode psychosis. The aim of this exploratory study was to examine whether employment duration over 18 months is associated with neurocognitive outcomes over 18 months among individuals with first-episode psychosis.
Eighty-eight young people with first-episode psychosis completed a neurocognitive battery at baseline and 18 months. Setwise (hierarchical) multivariate linear regressions were used to examine predictors of change in neurocognitive performance over 18 months. Total hours employed over 18 months were entered after accounting for age, gender, premorbid IQ, and negative symptom change scores.
Total hours employed was significantly associated with change in Symbol Digit Modalities Test raw score (p = .020), Letter-Number Sequencing scaled score (p = .016), Digit Span total scaled score (p = .047) and Rey Complex Figure Test delayed recall raw score (p = .016) over 18 months, after controlling demographic characteristics, premorbid IQ, and changes in negative psychotic symptoms.
Total hours worked over 18 months was associated with small improvements on one test of processing speed and one test of working memory. However, total hours worked over 18 months was also associated with decline on one test of attention and working memory and visual organization and memory. The findings implicate that work alone may not be entirely effective in changing neurocognitive functioning for young people with first-episode psychosis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
在精神分裂症患者群体中，就业时间的增加与特定神经认知领域的表现变化有关，但在首发精神病患者中并非如此。这项探索性研究的目的是检验在首发精神病患者中，超过18个月的就业时间是否与18个月后的神经认知结果相关。
88名首发精神病青年在基线和18个月时完成了一套神经认知测试。采用逐组（分层）多元线性回归来检验18个月内神经认知表现变化的预测因素。在考虑年龄、性别、病前智商和阴性症状变化分数后，纳入18个月内的总工作时长。
在控制了人口统计学特征、病前智商和阴性精神病症状变化后，18个月内的总工作时长与符号数字模式测验原始分数的变化显著相关（p = 0.020）、字母数字排序量表分数（p = 0.016）、数字广度总量表分数（p = 0.047）和雷氏复杂图形测验延迟回忆原始分数（p = 0.016）。
18个月内的总工作时长与一项处理速度测试和一项工作记忆测试的小幅改善有关。然而，18个月内的总工作时长也与一项注意力和工作记忆测试以及视觉组织和记忆测试的下降有关。研究结果表明，仅靠工作可能无法完全有效地改变首发精神病青年的神经认知功能。（PsycINFO数据库记录（c）2018美国心理学会，保留所有权利）
