Blackman Rachael Keir, Dickinson Dwight, Gregory Michael D, Kolachana Bhaskar S, Eisenberg Daniel P, Berman Karen F
Clinical and Translational Neuroscience Branch, National Institute of Mental Health, Intramural Research Program, 9000 Rockville Pike, Bethesda, MD 20892, USA.
Human Brain Collection Core, National Institute of Mental Health, Intramural Research Program, 9000 Rockville Pike, Bethesda, MD 20892, USA.
Schizophr Res Cogn. 2025 Mar 13;40:100356. doi: 10.1016/j.scog.2025.100356. eCollection 2025 Jun.
Although some individuals with schizophrenia are able to maintain gainful employment, many are not. To better understand this differential real-life outcome, we tested general and specific cognitive measures as predictors of future employment and genetic moderators of these relationships. One hundred and twenty-four patients with schizophrenia spectrum illness (31.5 % female, mean age 32.5 ± 10.5 years) participated in a research study at the National Institute of Mental Health Intramural Research Program's Clinical Center and were later recontacted regarding outcomes (average time to recontact = 8.6 ± 4.0 years). At the initial visit, patients completed a comprehensive battery of neuropsychological tests and provided blood samples for genotyping. Cognitive scores at the initial visit were tested as predictors of future employment status (employed vs. unemployed) at follow-up using logistic regressions, and polygenic risk scores for schizophrenia were tested as moderators. At follow-up, 45.2 % of individuals were employed. General cognitive ability indexes ("" and IQ) and verbal memory were predictive of subsequent employment status. Additionally, polygenic risk for schizophrenia moderated the effect of working memory cognitive scores on the prediction of future employment. The results suggest that certain broad indexes of cognitive dysfunction may be particularly salient in targeting interventions to address real-world functioning in schizophrenia. These data also suggest that further investigation into the genetic underpinnings of real-life outcomes in this illness is warranted.
虽然一些精神分裂症患者能够维持有酬工作，但许多人却不能。为了更好地理解这种现实生活中的差异结果，我们测试了一般和特定的认知指标作为未来就业的预测因素以及这些关系的基因调节因素。124名精神分裂症谱系疾病患者（31.5%为女性，平均年龄32.5±10.5岁）参与了美国国立精神卫生研究所内部研究项目临床中心的一项研究，随后就其结果进行了再次联系（再次联系的平均时间=8.6±4.0年）。在初次就诊时，患者完成了一系列全面的神经心理学测试，并提供了血液样本进行基因分型。使用逻辑回归将初次就诊时的认知分数作为随访时未来就业状况（就业与失业）的预测因素进行测试，并将精神分裂症的多基因风险分数作为调节因素进行测试。在随访时，45.2%的个体受雇。一般认知能力指标（“”和智商）以及言语记忆可预测随后的就业状况。此外，精神分裂症的多基因风险调节了工作记忆认知分数对未来就业预测的影响。结果表明，某些广泛的认知功能障碍指标在针对精神分裂症现实功能的干预措施中可能特别突出。这些数据还表明，有必要对该疾病现实生活结果的遗传基础进行进一步研究。
