RESUMENObjetivo: el déficit en los procesos cognitivos, específicamente en el rendimiento ejecutivo, de los pacientes con esquizofrenia se ha asociado con mala adaptación social. Un modelo factorial de las funciones ejecutivas permitiría detectar la asociación entre el perfil sintomático, el deterioro de la función ejecutiva y las necesidades de rehabilitación. El objetivo de esta investigación fue identificar factores de la función ejecutiva mediante un análisis factorial de las puntuaciones tipificadas de una serie de pruebas neuropsicológicas, en un grupo de pacientes ambulatorios con diagnósticos del espectro de la esquizofrenia. Metodología: estudio factorial mediante un análisis de componentes principales (ACP) con rotación ortogonal (varimax) de 13 medidas neuropsicológicas estandarizadas. Resultados: se obtuvieron tres factores independientes: (1) flexibilidad cognitiva, (2) control de la interferencia y memoria de trabajo y (3) velocidad de procesamiento y atención, que proporcionan una medición psicométrica adecuada del desempeño ejecutivo de los pacientes estudiados. Conclusiones: el análisis revela una estructura compleja de tres dimensiones cognitivas discretas que se pueden medir con una batería de uso común en la clínica. Palabras clave: análisis factorial; función ejecutiva; trastornos del espectro de la esquizofrenia. ABSTRACT Objective:The deficit in cognitive processes, specifically in executive function of patients with schizophrenia, has been associated with poor social adaptation. A factor model of executive functions would allow for the detection of the association between the symptomatic profile, the deterioration of the executive function, and rehabilitation needs. The objective of this study was to identify factors of the executive function through factor analysis of typified scores from a series of neuropsychological tests in a group of outpatients diagnosed with schizophrenia. Methodology: Factor study through principal components analysis (PCA) with orthogonal rotation (varimax) of 13 standardized neuropsychological measures. Results: Three independent factors were obtained: (1) cognitive flexibility, (2) interference control and working memory, and (3) processing speed and attention, which provide an adequate psychometric measurement of executive function in the patients studied. Conclusions: The analysis reveals a complex structure of three discrete cognitive dimensions that can be measured with cognitive assessment tools commonly used in the hospital.

Objective: To determine the rate of relapse in a cohort of patients with severe mental disorder (SMD), during a two year period, before joining a workplace reintegration program run by the Pere Mata Foundation (Reus, Tarragona, Spain) and to compare this information with the rate of relapse during the two subsequent years. We sought to compare both periods to determine if any differences existed in number of patients admitted and duration of stay, as well as the number of times the patients contacted the ambulatory facilities. Methods: A fixed historical cohort of 86 subjects with SMD was monitored for two years before, and for two years after, joining the workplace reintegration program. Results: The number of patients admitted to the hospital and the length of time they spent there decreased significantly after they had joined the program, as did the number of patients who contacted the ambulatory facilities. The length of time without relapses increased after joining the program (χ2 for Log Rank=4.46 df=1 p=0.035), and the rate of relapse before joining the program was 39% but fell to 18% after joining. The relative risk (RR) of having a relapse was greater during the observation period before joining the program than in the observation period after joining (RR 2.13 95% CI 1.27-3.55 p=0.002). Conclusions: Integrated clinical treatment combined with participation in a workplace reintegration program improved the clinical functioning of patients with SMD, decreased the number and length of hospital admissions, increased the length of time without relapse and reduced the patients' use of ambulatory facilities.