Prediction of Outcome in Schizophrenia

A Prospective Analysis of Work in Schizophrenia

“…Prior work history was related to history of the illness, including premorbid functioning, age at onset of schizophrenia, age at first hospitalization, and number of hospitalizations over the past 2 years. These findings are in general agreement with other research showing an association between work and premorbid functioning, age at onset of illness, and hospitalizations (Strauss and Carpenter 1977;Harrow et al 1986;MacEwan and Athawes 1997). Similarly, the relationships between work history and social functioning, cognitive impairment, and patient education are also consistent with prior research (Klorman et al 1977;Avison and Speechley 1987;Liddle 1987;Hoffman and Kupper 1997).…”

“…The competitive employment rates in this sample, ranging from about 10 percent following treatment for a symptom exacerbation to about 20 percent over the next 2 years, are similar to rates found in other surveys of persons with severe mental disorders (Anthony and Blanch 1987). Prior research has found that symptom exacerbations and rehospitalizations have a negative effect on employment and engagement in other vocational activities (Lorei and Gurel 1973;Strauss and Carpenter 1977;Blumenthal et al 1988;Mowbray et al 1995). The increase in both competitive employment and involvement in other vocational activity from the baseline assessment to the followup assessments suggests that the recent symptom exacerbation prior to baseline may have had a generally negative effect on work orientation, which subsequently increased over the following 2 years as symptoms stabilized.…”

Factor structure and construct validity of the Scale for the Assessment of Negative Symptoms.

“…This is interesting in light of other findings that “negative” symptoms are associated with poor neuroleptic response (Kane & Mayerhoff, 1989), poor prognosis (Fenton & McGlashan, 1991), and poor premorbid functioning (Peralta, Cuesta, & de Leon, 1991); these lines of evidence may indeed be relevant only for patients with little social drive and ability to experience pleasure during social contact. Indeed, this idea is consistent with other studies showing that a low number of social contacts and poor social adjustment are predictive of relapse and rehospitalization in schizophrenia (Harrow, Westermeyer, Silverstein, Strauss, & Cohler, 1986; Jonsson & Nyman, 1991; Rajkumar & Thara, 1989; Strauss & Carpenter, 1977). Future researchers might take this into account when examining neuropsychological deficits, morphology data such as ventricular size, and genetic evidence that may have implications for the etiology and development of schizophrenia and schizoaffective disorder.…”

The Multidimensional Scale of Independent Functioning: A New Instrument for Measuring Functional Disability in Psychiatric Populations

“…IQ and BPRS ratings shared between 5 and, in one instance, up to 34 percent of the variance with MSIF global ratings. This is consistent with previous reports relating ratings of disability with residual psychopathology (e.g., Strauss and Carpenter 1977) and cognitive functioning (e.g., Green 1996). Future studies will be needed to examine, more specifically, relationships between MSIF ratings and cognitive operations, including those that contribute to IQ.…”