Clinical and cognitive predictors of vocational outcome in first-episode schizophrenia: A prospective 3 year follow-up study

Abstract Schizophrenia is associated with pronounced vocational impairment. Previous research has mostly focused on chronic patients and few studies were conducted to investigate predictors of work outcome in first-episode populations. The impact of cognitive dysfunction on employment outcome in ear...

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Published in:	Psychiatry research 2014-12, Vol.220 (3), p.834-839
Main Authors:	Chang, Wing Chung, Man Tang, Jennifer Yee, Ming Hui, Christy Lai, Wa Chan, Sherry Kit, Ming Lee, Edwin Ho, Hai Chen, Eric Yu
Format:	Article
Language:	eng
Subjects:	Adult Adult and adolescent clinical studies Biological and medical sciences Cognition Disorders - diagnosis Cognition Disorders - epidemiology Cognition Disorders - psychology Cognitive impairment Cohort Studies Employment Employment - psychology Employment - trends Executive function Female First-episode schizophrenia Follow-Up Studies Humans Male Medical sciences Neuropsychological Tests Predictive Value of Tests Prospective Studies Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Schizophrenia Schizophrenia - diagnosis Schizophrenia - epidemiology Schizophrenic Psychology Vocational outcome Young Adult
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Summary:	Abstract Schizophrenia is associated with pronounced vocational impairment. Previous research has mostly focused on chronic patients and few studies were conducted to investigate predictors of work outcome in first-episode populations. The impact of cognitive dysfunction on employment outcome in early psychosis was under‐studied. In this study, we prospectively followed up 93 patients aged 18–55 years presented with first-episode schizophrenia-spectrum disorder for 3 years with an aim to identify early clinical and cognitive predictors of vocational outcome. Pre-morbid adjustment, baseline symptomatology and cognitive functions, and employment outcome were assessed. Result indicated that approximately half of the patients (53.8%) were engaged in full-time work at intake and at 3 years. Pre-morbid adjustment, baseline occupational status and Wisconsin Card Sorting Test (WCST) performance were found to predict vocational outcome. Analysis on a subgroup of patients who were unemployed at intake showed that subjects who remained unemployed over 3 years had poorer WCST performance and more severe positive symptoms at baseline than those having job attainment during follow-up. Our results thus confirmed predictive value of pre-morbid functioning and baseline occupational status on vocational outcome. In addition, our findings suggested that executive function might be a critical cognitive determinant of employment outcome in the early course of schizophrenia.
ISSN:	0165-1781 1872-7123