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Clinical and cognitive predictors of vocational outcome in first-episode schizophrenia: A prospective 3 year follow-up study
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.
- This study aimed to identify pre-treatment and early clinical and cognitive predictors of employment outcome in patients with first-episode schizophrenia-spectrum disorder.
- Approximately half of the patients had full-time work at intake and at 3 years.
- Pre-morbid adjustment, baseline occupational status and executive function independently predicted employment outcome.
Keywords: Employment, Vocational outcome, Executive function, Cognitive impairment, First-episode schizophrenia.
© 2014 Elsevier Ireland Ltd, All rights reserved.