Determinants of work outcome in neuroleptic-resistant schizophrenia and schizoaffective disorder: Cognitive impairment and clozapine treatment

Yasuhiro Kaneda*, Karuna Jayathilak, Herbert Meltzer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

There is considerable evidence that cognitive impairment is a better predictor of work and social function in schizophrenia than are positive and negative symptoms. Atypical antipsychotic drugs have been shown to improve cognitive function in schizophrenia patients, but it is unclear whether this improves patients' ability to gain employment. Data from a prospective longitudinal study was used to test the hypotheses that (1) clozapine treatment would improve employment outcome in treatment-resistant schizophrenia or schizoaffective disorder patients, and (2) specific cognitive functioning at baseline and after treatment would predict work status at baseline and change in work status. Employment status and cognitive assessment data were collected in 59 treatmentresistant schizophrenia or schizoaffective disorder patients. Forty-seven of 59 (79.7%) patients were unemployed at baseline. Over a 12-month period, 23 (48.9%) additional patients were able to gain paid or volunteer jobs, or attend school. As predicted, neurocognitive performancewas a better predictor of employment status and ability to gain of employment than clinical symptoms. Improvement in verbalworking memorywas found to be a better predictor of employment outcome than other cognitive functions. Treatment that enhances cognitive function, especially verbal workingmemory, may lead to better employment outcomes in treatment-resistant schizophrenia or schizoaffective disorder patients.

Original languageEnglish (US)
Pages (from-to)57-62
Number of pages6
JournalPsychiatry Research
Volume178
Issue number1
DOIs
StatePublished - Jun 30 2010

Keywords

  • Adult
  • Open studies
  • Pharmacotherapy
  • Verbal working memory

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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