Full text
| |
| Author(s): |
Danielle Soares Bio
Total Authors: 1
|
| Document type: | Master's Dissertation |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2010-06-23 |
| Examining board members: |
Wagner Farid Gattaz;
Ana Cristina Chaves;
Paulo Clemente Sallet
|
| Advisor: | Wagner Farid Gattaz |
| Abstract | |
Several studies in schizophrenia found a positive association between cognitive performance and work status, and it has been reported that good cognitive performance at the outset does predict the success of vocational interventions. However little has been done to investigate the influence of vocational interventions itself on cognitive performance. It has been hypothesized that vocational interventions may compensate for impairments in the most basic cognitive functions, which in turn may reflect in improvements in more complex cognitive domains. To test this hypothesis we performed a randomized, placebo-controlled trial to investigate in remitted schizophrenic patients the effect of a 6-months vocational rehabilitation program on cognitive performance. We recruited 112 remitted and clinically stable schizophrenic patients who aimed to enter a vocational rehabilitation program. From these, 57 immediately entered a 6-months vocational rehabilitation program, and the remaining 55 formed our control group, which received out-clinic follow-up treatment during these 6 months. Besides a thorough neuropsychological test battery, we also assessed changes in the psychopathological status by means of the Positive and Negative Symptoms Scale (PANSS), and a Quality of Life Scale (QLS). We found that vocational rehabilitation significantly improved patients\' performance in cognitive measures that assess executive functions (concept formation, shifiting ability, flexibility, inhibitory control, and judgment and critics abilities). Moreover, after 6 months the vocational group improved significantly in the negative symptoms and in quality of life, as compared to controls. The model of logistic regression, pointed that the success of the vocational rehabilitation is related to a greater value of QI and a worse score in the total PANSS. Together with results from the literature, our findings reinforce the notion that the inclusion of vocational interventions does enhance the effectiveness of therapeutic strategies for schizophrenia patients. (AU) | |