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Chika Sumiyoshi, Tomiki Sumiyoshi, Haruo Fujino, Hidenaga Yamamori, Yuka Yasuda, Noriko Kudo, Michiko Fujimoto, Manabu Ikeda, Ryota Hashimoto, SA42. Impact of Intelligence Decline on Work Outcome in Patients With Schizophrenia, Schizophrenia Bulletin, Volume 43, Issue suppl_1, March 2017, Page S128, https://doi.org/10.1093/schbul/sbx023.041
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Abstract
Background: The trajectory of intelligence/cognitive abilities in the course of illness may vary across patients with schizophrenia (Weickert et al., 2000). Specifically, a subgroup of patients whose intelligence are preserved has been shown to elicit a relatively favorable outcome in terms of occupation/employment, compared to patients with declining intelligence (Lesson et al., 2011). The purpose of this study was to determine whether IQ decline due to the development of schizophrenia, in combination with other clinical factors, would predict work outcome.
Methods: Subjects: One hundred and thirty three Japanese patients meeting DSM-IV-TR criteria for schizophrenia (mean age = 37.17, SD = 12.40) entered the study. This study was approved by the ethics committee of Osaka University.
Assessment: Current and premorbid intelligence levels (IQ) were assessed by the Wechsler Adult Intelligent Scale (WAIS)-3 (FIQ) and the Japanese version of the Adult Reading Test (JART), respectively. Intelligence decline was estimated by subtracting the current IQ from premorbid IQ. Functional outcomes were assessed by the UCSD Performance-based Skills Assessment-Brief (UPSA-B) Japanese version, Social Functioning Scale Individuals’ version Modified for MATRICS-PASS (SFS), and Japanese version of Subjective Quality of Life Scale (JSQLS).
Analyses: The following variables were entered into logistic regression analysis to predict better (> 20 hours/week) or poor (< 20 hours/w) work outcome: IQ (JART, FIQ, FIQ-JART), functional outcome (UPSA-B, SFS, JSQLS), Positive and Negative Syndrome Scale (PANSS) Total scores, age at onset, and education. Work hours were obtained with the Social Activity Assessment.
Results: Scores on the SFS Composite, calculated by excluding Employment/Occupation subscale scores, FIQ-JART, and PANSS Total remained as significant variables in the logistic regression, yielding around 80% accuracy for classifying better versus poor work outcome groups.
Conclusion: The current study suggests that the difference between premorbid IQ and current IQ provides a feasible indicator of work outcome; patients with a lesser decline are likely to work better. Future studies are warranted to address why IQ decline, rather than current IQ, more greatly affects work functioning in patients with schizophrenia.
References
1. Leeson, V. C. et al., 2011. Schizophr Bull., 37, 768–777.
2. Weickert, T. W. et al., 2000. Arch Gen Psychiatry, 57, 907–913.
