Biomedical subjects

Gary Bryson

Publications and source records attributed to Gary Bryson.

6 recordsLinked to original sources

PubMed2005

The implications of memory profiles in schizophrenia on vocational and neuropsychological functioning.

Studies in schizophrenia suggest that verbal learning and memory may distinguish three subgroups of patients: an unimpaired memory profile group and two groups that have memory profiles similar to those seen in cortical and subcortical dementias. Using the Hopkins Verbal Learning Test, Revised edition (HVLT-R), this study attempted to differentiate patients into three memory profile groups and to examine the validity of these groups with respect to vocational outcomes and neuropsychological functioning. Results from this study replicated previous findings and extended them by demonstrating a link to vocational outcome. In addition, the proportion of patients in each group closely resembled that obtained in previous studies. Specifically, the relatively unimpaired memory group (42%) showed overall better memory and neuropsychological performance than the two impaired groups, the subcortical group (38%) showed impaired recall but intact recognition and deficits in visuospatial functioning, and the cortical group (20%) showed deficits in recall, recognition, and sustained attention/executive functioning. There were no clinical differences between the three groups, but both the unimpaired and subcortical groups increased the number of hours worked following a vocational rehabilitation program. Given these differences, more research is warranted to explore the effect of memory impairment subtypes on vocational outcome measures.

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PubMed2004

Effects of neurocognitive enhancement therapy in schizophrenia: normalisation of memory performance.

INTRODUCTION: A preponderance of research indicates that cognitive function in schizophrenia can be improved through cognitive remediation. However, few studies have attempted to characterise the extent of improvement relative to nonpsychiatric controls. METHOD: Cognitive performance on reaction time, digit recall, and word recall of 58 schizophrenia patients at baseline and after 6 months of cognitive remediation was compared to the performance on these tasks of 39 community controls. Schizophrenia patients participated in Neurocognitive Enhancement Therapy (NET) and received hierarchical training on the memory tasks, but not on the reaction time task, which was only administered at intake and follow-up. RESULTS: The schizophrenia sample showed significantly poorer performances than the community control sample on all three tasks at baseline. NET led to significant improvements in performance on trained memory tasks, but not the untrained reaction time task. There was a significant increase in the proportion of schizophrenia patients who achieved normal range performance on the memory tasks. CONCLUSIONS: 52% of schizophrenia patients who were impaired on at least one of the memory tasks normalised their performance on at least one of those tasks as a result of cognitive training. Results suggest that clinically meaningful improvement may be possible using cognitive remediation.

Journal Article↗

PubMed2003

Initial and final work performance in schizophrenia: cognitive and symptom predictors.

Studies have shown that cognitive functioning may limit the rate, tenure, and type of work performed by people with schizophrenia. The present study tested the hypothesis that cognitive abilities needed for initial improvement in work performance would differ from those needed in later vocational development. Ninety-six outpatients with schizophrenia or schizoaffective disorder who participated in a work rehabilitation program were administered neuropsychological testing at intake. Their work performance was evaluated biweekly for 26 weeks. Cognitive test variables were entered into regressions predicting the slope of individual performance curves from weeks 1 to 13 and 13 to 26. Neuropsychological variables accounted for 28% of the variance in slope during the initial period. The strongest predictor was a Continuous Performance Task variable that measures inattentiveness. Other important variables were measures of idiosyncratic thinking, cognitive flexibility, and verbal memory. Neuropsychological variables accounted for 19% of the variance in the slope during the final period. The strongest predictor was verbal learning, while measures of cognitive impulsivity and psychomotor functioning were also significant contributors. There was no relationship between work performance and symptoms for weeks 1 to 13 or 13 to 26. These findings suggest that while attention is more important for initial success, verbal memory becomes more important for sustained improvement. Remediating or accommodating such deficits in a time-sensitive fashion may be a necessary feature for successful rehabilitation.

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PubMed2002

Quality of life benefits of paid work activity in schizophrenia.

In a study of work rehabilitation, 97 participants with schizophrenia or schizoaffective disorder were randomized into either a Pay or a No Pay condition to determine the impact of work activity and pay on rehabilitation outcomes. This report specifically investigates the relationship between work rehabilitation and quality of life (QOL) measures for people with schizophrenia. Previous reports have described improvements in symptoms and work outcomes for participants in the Pay condition. Results in this report reveal that randomization to the Pay condition improved ratings on the Heinrichs Quality of Life Scale (QLS). The improvements are found both in overall QLS and in the domain of Intrapsychic Foundations (motivation, sense of purpose, anhedonia, and empathy). For a larger sample (n = 114) we assessed the relationship between amount of participation and QLS improvement. Degree of participation was related to improvement on the QLS total and Intrapsychic Foundations domain. Finally, improvement in the Interpersonal Relations scale was associated with weeks of participation for the most consistent participants. How participation in work rehabilitation and its interaction with pay improves motivation, interpersonal relatedness, and overall quality of life is discussed.

Adult↗

PubMed2002

Work rehabilitation and patterns of substance use among persons with schizophrenia.

OBJECTIVE: The aim of this study was to identify patterns of substance use among participants in work rehabilitation, to identify symptom patterns associated with substance use, and to assess the impact of substance use on work rehabilitation outcomes. METHODS: Addiction Severity Index interviews were conducted and Positive and Negative Syndrome Scale ratings were obtained at the start of the study and again five months and 12 months later for 220 patients with schizophrenia or schizoaffective disorder who were already enrolled in a study of work rehabilitation. RESULTS: Eighty percent of the participants met Addiction Severity Index criteria for lifetime substance use, but 75 percent were abstinent at intake. During the 12-month follow-up period, abstinence rates remained above 66 percent. Participants with a lifetime history of cocaine use were more likely to return to substance use. The type of substance used was also related to distinct symptom patterns. Participants with past cocaine use had more severe hostility symptoms and less severe negative symptoms. No significant relationships were found between lifetime or current substance use and participation in the work rehabilitation program. CONCLUSIONS: Even though a high rate of lifetime substance use was observed in this sample, most participants were in stable remission of substance use throughout the one-year study. Substance use and work participation appeared to be semiautonomous: substance use did not directly affect work participation, and work participation did not directly affect substance use.

Adult↗

PubMed2002

Longitudinal Wisconsin card sorting performance in schizophrenia patients in rehabilitation.

UNLABELLED: Recent investigations into the course of cognitive functioning in schizophrenia have not been able to determine whether cognitive functioning declines, remains stable, or improves over time. This report analyzes Wisconsin Card Sorting Test (WCST) and Wechsler Adult Intelligence Test-Revised Digit Symbol Substitution Test (WAIS-R DSST) performance over time to determine if there is deterioration, improvement, or stability of performance. Data for 46 participants, diagnosed with schizophrenia or schizoaffective disorder that were in a stable phase of illness and actively involved in rehabilitation, were gathered from assessments made at 2 time points on average 4.3 years apart. Results indicated that there was stability in most WCST variables; however, there was significant improvement on WCST perseverative error and on the DSST. Sixty-five percent of the sample improved on 1 or both of the test variables. Furthermore, cognitive test changes were unrelated to type of psychotropic medication and only modestly related to symptom variables. Results indicate that in a stable schizophrenia sample, WCST performance is generally stable over the 3- to 7-year time period, but there are some cognitive variables that may improve even without direct intervention. KEYWORDS: schizophrenia, cognition, executive function, rehabilitation, stability

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