Factors predicting work outcome in Japanese patients with schizophrenia: role of multiple functioning levels

Abstract

Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals’ version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60–70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.

Possible Facilitative Effects of Repeated Anodal Transcranial Direct Current Stimulation on Functional Outcome 1 Month Later in Schizophrenia: An Open Trial

“…To our knowledge, there has been no attempt to elucidate the effect of tDCS on this level of functional outcomes in psychiatric conditions. In view of the association between performance on the UPSA-B and real-world functional outcomes ( 43 ), the result reported here suggests the ability of tDCS to enhance social outcome in schizophrenia.…”

The Comparative Effects of Risperidone Long-Acting Injection and Paliperidone Palmitate on Social Functioning in Schizophrenia: A 6-Month, Open-Label, Randomized Controlled Pilot Trial

“…On the other hand, the SFS has 7 domains and assigns points to items on each domain. The sum of these domain scores provides the total score of social functioning [21,22]. …”

“…Finally, Harvey et al [47] suggested that self-reporting is a problematic way to assess functioning, because patients with schizophrenia often show a reduced awareness of their psychotic symptoms. On the other hand, Sumiyoshi et al [22] reported that patients' SFS data are highly correlated with informants' data and with informant-based objective measures.…”

“…Social functioning was assessed using the SFS [21,22]. The SFS is an informant report completed by the patient or a relative.…”

Semantic Memory Organization in Japanese Patients With Schizophrenia Examined With Category Fluency

“…Although those “gold-standard” cognitive batteries have been reported to be effective for predicting functional outcomes in patients with schizophrenia ( 7 ), the target domains are mainly executive aspects of cognition (i.e., attention, processing speed, and visual/verbal working memory). Higher order cognition, such as semantic memory, has received less attention, although disorganization of semantic memory has been considered as one of the intermediate cognitive phenotypes in patients with schizophrenia ( 8 ).…”