Neurocognition and occupational functioning in patients with first-episode psychosis: a 2-year follow-up study |
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Authors: | Tandberg Marte Ueland Torill Sundet Kjetil Haahr Ulrik Joa Inge Johannessen Jan Olav Larsen Tor Ketil Opjordsmoen Stein Rund Bjørn Rishovd Røssberg Jan Ivar Simonsen Erik Vaglum Per Melle Ingrid Friis Svein McGlashan Thomas |
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Institution: | a Division of Mental Health and Addiction, Oslo University Hospital, 0407 Oslo, Norwayb Department of Psychology, University of Oslo, P.O. Box 1094 Blindern, 0317 Oslo, Norwayc Insitute of Clinical Medicine, Section of Psychiatry, University of Oslo, Oslo, Norwayd Stavanger University Hospital, Division of Psychiatry, Regional Center for Clinical Psychosis Research, Stavanger, Norwaye Early Psychosis Intervention Center and University of Copenhagen, Zealand Region Psychiatry Roskilde, Roskilde, Denmarkf Department of Clinical Medicine, Section Psychiatry, University of Bergen, Bergen, Norwayg Vestre Viken Hospital Trust, Drammen, Norwayh Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde University and University of Copenhagen, Copenhagen, Denmarki Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norwayj School of Medicine, Yale University, New Haven, CT, USA |
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Abstract: | Neurocognitive deficits are a core feature of schizophrenia that is associated with poor occupational functioning. Few studies have investigated this relationship in patients with first-episode psychosis. The current study examined the characteristics of employed and unemployed patients with first-episode psychosis at baseline and 2-year follow-up, and the predictive value of neurocognition on employment status. One-hundred and twenty-two first-episode psychosis patients were assessed with clinical and neurocognitive measures at baseline. Occupational status was assessed at baseline and 2-year follow-up. Those unemployed at baseline were rated lower on global functioning and were more likely to have a schizophrenia spectrum disorder. Total employment rates were 41% at baseline and 38% at 2-year follow-up. Four employment paths emerged at follow-up, defined as persistently employed, becoming unemployed, entering employment and persistently unemployed. The persistently employed group had the highest global functioning score. For the total sample, baseline employment status and sustained attention predicted employment status at follow-up. For those employed at baseline, better sustained attention, higher global functioning, more positive symptoms and less alcohol use predicted persistent employment at follow-up. For those unemployed at baseline, none of the variables predicted change in employment status. Implications of these results are discussed. |
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Keywords: | First-episode psychosis Neurocognition Occupational functioning Neurocognitive functioning Functional outcome Employment |
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