Clinical and cognitive correlates of employment among patients with schizophrenia: a cross-sectional study in Malaysia

Abstract

BackgroundGainful employment is one major area of functioning which is becoming an important goal in psychiatric rehabilitation of patients with schizophrenia. Studies in western countries are pointing to evidence that certain sociodemographic and clinical factors may contribute to employment outcomes in this group of people. However, the area is still largely unexplored in Malaysia. The aim of this study was to examine the sociodemographic, clinical and cognitive correlates of employment status among patients with Schizophrenia.MethodsThis was a cross-sectional study. All participants who fulfilled the requirements of the study according to the inclusion and exclusion criteria were enrolled. Study instruments included a demographic data questionnaire, Positive and Negative Symptom Scale (PANSS), Trail Making Tests, Rey's Auditory Verbal Learning Test (RAVLT) and Digit Span. Bivariate analyses were done using chi-square for categorical data and t-test for continuous data and multiple logistic regression analysis was done to identify predictors of employment status.ResultsA total of 95 participants who fulfilled the inclusion criteria were enrolled into the study. Among the sociodemographic, clinical and cognitive variables studied marital status, educational level, mean scores of negative symptoms, Digit Span and RAVLT and Trail Making Tests were found to show significant association with employment status on bivariate analyses. However, when entered into a logistic regression model, only cognitive variables ie. Trail A and B, Digit Span and RAVLT were significant predictors of employment status.ConclusionsThe results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the importance of integrating cognitive rehabilitation in the psychosocial rehabilitation program for patients with schizophrenia in Malaysia.

Functional remission and employment among patients with schizophrenia in Malaysia

“…This finding was replicated in another study among people with schizophrenia attending an outpatient clinic setting [6]. This lower rate compared to those of the Western countries may be partly due to the studies employing a looser term of employment.…”

Relationship Suicide, Cognitive Functions, and Depression in Patients with Schizophrenia

“…Among these processes are verbal learning, immediate spatial memory, backward masking effect, free recall, and recognition memory. In this study, the scores that are extensively used in literature such total recall score (A1-5), post-interference recall score, (A6), and delayed recall score (A7) were used (30,31). The original version of the test was developed by Rey in 1940 and was revised by Taylor in 1959.…”

Predictors of vocational status in schizophrenia patients – Results from the Polish nationwide survey

“…In light of high prevalence of unemployment, previous studies have aimed at investigating factors that predict poor vocational status in this group of patients. Inconsistent results indicate that such demographic variables as gender ( Beiser et al, 1994 ; Harrison, Croudace, Mason, Glazebrook, & Medley, 1996 ; McCreadie, 1982 ; Ran et al, 2011 ; Ucok et al, 2012 ), educational attainment ( Cougnard, Goumilloux, Monello, & Verdoux, 2009 ), previous work history ( Mueser, Salyers, & Mueser, 2001 ; Schennach-Wolff, Musil, Moller, & Riedel, 2012 ), marital status ( Evert, Harvey, Trauer, & Herrman, 2003 ; Loganathan & Murthy, 2011 ; Midin et al, 2011 ; Srinivasan & Thara, 1997 ) and rural or urban environment ( Munk-Jorgensen & Mortensen, 1992 ; Yang et al, 2013 ) are associated with vocational outcome. In turn, the following clinical factors have been found to increase unemployment rates: severity of negative symptoms ( Erickson, Jaafari, & Lysaker, 2011 ; Marwaha et al, 2009 ; Schennach-Wolff et al, 2009 ), impaired insight ( Erickson et al, 2011 ), cognitive dysfunction ( Tsang, Leung, Chung, Bell, & Cheung, 2010 ), duration of untreated psychosis ( Chang et al, 2012 ) and older age of schizophrenia onset ( Ran et al, 2011 ), comorbid metabolic syndrome ( Medeiros-Ferreira, Obiols, Navarro-Pastor, & Zuniga-Lagares, 2013 ) and the number ( Lay, Blanz, Hartmann, & Schmidt, 2000 ) and duration ( Nordt, Muller, Rossler, & Lauber, 2007 ) of hospitalizations.…”