Cognitive performance and occupational functioning in first episode schizophrenia: an exploratory study

Abstract

The present study adopted a prospective design to investigate the relationship between neurocognitive performance and occupational functioning in a group of first-episode schizophrenic patients (51 males, 64 females) at 16-month follow-up. The mean age of onset and educational level were 31.8 years (SD = 9.3. and 10.4 years (SD = 3.2), respectively. A set of neurocognitive tests tapping attention (continuous performance test, digit forward span), memory (logical memory, visual reproduction) and executive function (verbal fluency, Wisconsin card sorting test) were implemented to all participants upon discharge and at 16-month interval. Psychotic symptoms and occupational functioning were measured by Positive and Negative Symptoms Scale (PANSS) and “work” sub-scale of Disability Assessment Schedule (DAS). Significant correlations were found between the “work” sub-scale score at 16-month interval and early cognitive function as well as psychotic symptoms: verbal fluency (r = -0.314, p < 0.05), visual reproduction (r = -0.488, p < 0.001), negative symptoms (r = 0.57, p < 0.0005) and total symptoms (0.561, p < 0.0005). Regression analysis further demonstrated that total PANSS score (Beta = 0.46, R2 = 0.33. and visual reproduction (Beta = -0.31, R2 = 0.08) were the only significant predictors of “work” sub-scale of DAS. These findings suggest that although occupational functioning at 16 months could be related to cognitive performance and negative symptom level discharge from the first illness episode.