| 1 | Rehabilitation (Stuttg) 2004 Dec 43: 368-74 |
|---|---|
| PMID | 15565538 |
| Title | [The Osnabruck Work Capabilities Profile (O-AFP) for persons with psychiatric illness: concept, development, and testing in schizophrenic patients]. |
| Abstract | The goal of this paper is presentation of an inventory for the assessment of basic capabilities underlying work and occupational behaviour of psychiatric patients in the course of their treatment and rehabilitation. The "Osnabruck Work Capabilities Profile" (O-AFP) is an instrument filled in by staff, which consists of three scales comprising ten items each, measuring "Learning Ability", "Social Communication Ability" and "Adaptation". In the study presented, these scales were confirmed by factor analyses of data from 194 schizophrenic patients. Test analyses yielded good item and scale characteristics. The only exception to this are elevated item difficulty scores of the third scale (adaptation). This was attributed to specific effects of selecting the sample of patients. Furthermore, low or insignificant correlations with the patients' symptom scores indicate the discriminant validity of the scales. It is concluded that the O-AFP is well suited for application with different forms of occupational therapy. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 2 | Fortschr Neurol Psychiatr 2005 Nov 73: 674-80 |
| PMID | 16283611 |
| Title | [Which schizophrenic patients improve under work therapy, which ones don't?]. |
| Abstract | This investigation is part of a multicenter study, where only small effects and no superiority compared to creative ergotherapy was found for four weeks of inpatient work therapy. The criteria were three scales of the Osnabrück-Working Capabilities Profile (O-AFP) assessing basic learning ability, social communication ability and adaptation at the work place. The goal of this investigation is to identify subgroups of patients within the work therapy group, which differ in their course of ability level during the intervention. Three subgroups were identified for each scale. Subgroups with improvements comprise 24 % (learning ability) and 15 % (social communication) of the sample. Adaptation level decreases in a group of 9 % of the patients. The remaining clusters show constancy of abilities at different levels. Comparison of the clusters with neurocognitive, symptom and motivational variables shows that for learning ability mainly neurocognitive variables yield salient differences, whereas for social communication abilities, symptoms and motivation, together with a specific aspect of memory, seem to be characteristic. Only positive symptoms are related to adaptation. Also, there are hints for variables that specifically characterize patients with improvement of ability level. The discussion deals with issues of assessment and prognosis in rehabilitation, contributions to the neurocognitive theory of schizophrenia and to the development of person-centered interventions. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 3 | Fortschr Neurol Psychiatr 2005 Nov 73: 674-80 |
| PMID | 16283611 |
| Title | [Which schizophrenic patients improve under work therapy, which ones don't?]. |
| Abstract | This investigation is part of a multicenter study, where only small effects and no superiority compared to creative ergotherapy was found for four weeks of inpatient work therapy. The criteria were three scales of the Osnabrück-Working Capabilities Profile (O-AFP) assessing basic learning ability, social communication ability and adaptation at the work place. The goal of this investigation is to identify subgroups of patients within the work therapy group, which differ in their course of ability level during the intervention. Three subgroups were identified for each scale. Subgroups with improvements comprise 24 % (learning ability) and 15 % (social communication) of the sample. Adaptation level decreases in a group of 9 % of the patients. The remaining clusters show constancy of abilities at different levels. Comparison of the clusters with neurocognitive, symptom and motivational variables shows that for learning ability mainly neurocognitive variables yield salient differences, whereas for social communication abilities, symptoms and motivation, together with a specific aspect of memory, seem to be characteristic. Only positive symptoms are related to adaptation. Also, there are hints for variables that specifically characterize patients with improvement of ability level. The discussion deals with issues of assessment and prognosis in rehabilitation, contributions to the neurocognitive theory of schizophrenia and to the development of person-centered interventions. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 4 | Psychiatr Prax 2006 Nov 33: 383-9 |
| PMID | 17128396 |
| Title | [Vocational therapy in schizophrenia: effects only with some patients and with which patients?]. |
| Abstract | In a previous study the effectiveness of vocational therapy was evaluated using the Osnabrück Profile of Working Abilities (O-AFP). No or only minor effects were detected. The goal of this reanalysis is to identify distinct responder groups. Hierarchical cluster analysis of O-AFP-scores before and after treatment, anovas, t-statistics as well as regression and discriminant analyses were applied to specify the clusters. For each of the O-AFP-scales (Learning Ability, Social Communication Ability, Adaptation) three subgroups different in level and slope of abilities could be identified. Improvements with medium to high effect sizes were detected for Social Communication Ability (34 %) and Learning Ability (14 % of the patients), deterioration was found in 30 % of the patients for Adaptation. Subgroups could be described with the help of symptomatology. Further variables and subgroup membership could be predicted above chance by discriminant and regression analysis. Targeted and more appropriate design of vocational therapy seems necessary. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 5 | Eur Child Adolesc Psychiatry 2015 Dec 24: 1447-59 |
| PMID | 25726022 |
| Title | Functional deterioration from the premorbid period to 2 years after the first episode of psychosis in early-onset psychosis. |
| Abstract | The aim of the study was to analyze changes in functional adjustment from childhood to 2 years after the first episode of psychosis (FEP) in patients with early-onset schizophrenia spectrum disorders (SSD) and affective psychoses (AFP) and a good or intermediate level of premorbid adjustment. We followed 106 adolescents (aged 12-17 years) with FEP for 2 years after recruitment. Premorbid adjustment in childhood was assessed in 98 patients with the childhood subscale of the Cannon-Spoor Premorbid Adjustment Scale (c-PAS). Global functioning was assessed 2 years after the FEP with the Children's Global Assessment Scale (c-GAS) or the Global Assessment of Functioning scale (GAF), as appropriate. Functional deterioration was defined as a downward shift in the level of functional adjustment from childhood to 2 years after the FEP. In patients with good or intermediate premorbid adjustment, functional deterioration was observed in 28.2 % (26.5 % of the AFP group, 29.4 % of the SSD group). Longer duration of untreated psychosis (Beta = 0.01; P = 0.01) and higher symptom severity at the FEP, as measured with the Clinical Global Impression Scale (Beta = 1.12; P = 0.02), significantly predicted the presence of functional deterioration, accounting for 21.4 % of the variance. Irrespective of diagnosis (SSD or AFP), almost one-third of adolescents with FEP and good or intermediate premorbid adjustment showed functional deterioration from the premorbid period to 2 years after the FEP. |
| SCZ Keywords | schizophrenia, schizophrenic |
| 6 | Schizophr Bull 2016 Mar 42: 344-57 |
| PMID | 26371339 |
| Title | Age at First Episode Modulates Diagnosis-Related Structural Brain Abnormalities in Psychosis. |
| Abstract | Brain volume and thickness abnormalities have been reported in first-episode psychosis (FEP). However, it is unclear if and how they are modulated by brain developmental stage (and, therefore, by age at FEP as a proxy). This is a multicenter cross-sectional case-control brain magnetic resonance imaging (MRI) study. Patients with FEP (n = 196), 65.3% males, with a wide age at FEP span (12-35 y), and healthy controls (HC) (n = 157), matched for age, sex, and handedness, were scanned at 6 sites. Gray matter volume and thickness measurements were generated for several brain regions using FreeSurfer software. The nonlinear relationship between age at scan (a proxy for age at FEP in patients) and volume and thickness measurements was explored in patients with schizophrenia spectrum disorders (SSD), affective psychoses (AFP), and HC. Earlier SSD cases (ie, FEP before 15-20 y) showed significant volume and thickness deficits in frontal lobe, volume deficits in temporal lobe, and volume enlargements in ventricular system and basal ganglia. First-episode AFP patients had smaller cingulate cortex volume and thicker temporal cortex only at early age at FEP (before 18-20 y). The AFP group also had age-constant (12-35-y age span) volume enlargements in the frontal and parietal lobe. Our study suggests that age at first episode modulates the structural brain abnormalities found in FEP patients in a nonlinear and diagnosis-dependent manner. Future MRI studies should take these results into account when interpreting samples with different ages at onset and diagnosis. |
| SCZ Keywords | schizophrenia, schizophrenic |