ABSTRACT
BACKGROUND: Given the wealth of data in the literature on schizophrenia endophenotypes, it is useful to have one source to reference their frequency data. We reviewed the literature on disease-liability associated variants in structural and functional magnetic resonance images (MRI), sensory processing measures, neuromotor abilities, neuropsychological measures, and physical characteristics in schizophrenia patients (SCZ), their first-degree relatives (REL), and healthy controls (HC). The purpose of this review was to provide a summary of the existing data on the most extensively published endophenotypes for schizophrenia. METHODS: We searched PubMed and MedLine for all studies on schizophrenia endophenotypes comparing SCZ to HC and/or REL to HC groups. Percent abnormal values, generally defined as >2 SD from the mean (in the direction of abnormality) and/or associated effect sizes (Cohen's d) were calculated for each study. RESULTS: Combined, the articles reported an average 39.4% (SD=20.7%; range=2.2-100%) of abnormal values in SCZ, 28.1% (SD=16.6%; range=1.6-67.0%) abnormal values in REL, and 10.2% (SD=6.7%; range=0.0-34.6%) in HC groups. CONCLUSIONS: These findings are reviewed in the context of emerging hypotheses on schizophrenia endophenotypes, as well as a discussion of clustering trends among the various intermediate phenotypes. In addition, programs for future research are discussed, as instantiated in a few recent large-scale studies on multiple endophenotypes across patients, relatives, and healthy controls.
Subject(s)
Phenotype , Schizophrenia/genetics , Biomarkers , Cluster Analysis , Cognition Disorders/diagnosis , Cognition Disorders/genetics , Cognition Disorders/psychology , Family , Humans , Schizophrenia/diagnosis , Schizophrenic Psychology , Statistics as TopicABSTRACT
Vocational rehabilitation (VR) supervisors and counselors (n = 35) as well as supported employment (SE) program managers and employment specialists (n = 26) were enrolled in a 12-month evaluation comparing two models of funding services for persons with severe mental illness: fee-for-service and results-based funding (RBF). Quantitative measures of job satisfaction and preference for funding method were obtained prospectively on a quarterly basis, and SE staff activity logs were collected monthly. Qualitative data were collected using a series of focus groups conducted at the conclusion of the study. Despite recording a substantial increase in semi-annualized VR billing charges when using RBF (45-49%), SE staff expressed less satisfaction with RBF over time. Staff raised concerns about increased financial risks and pressures to achieve job placements under RBF. Vocational rehabilitation staff were consistently more satisfied with RBF, expressing particular satisfaction with perceived effectiveness and the payment authorization process. Both VR and SE staff expressed some reservations about RBF, primarily concerning possible pressures for adverse client selection.
Subject(s)
Employment, Supported/economics , Fee-for-Service Plans , Mental Disorders/economics , Mental Disorders/rehabilitation , Rehabilitation, Vocational/economics , Reimbursement, Incentive , Focus Groups , Humans , Job Satisfaction , Occupational Health Services/economics , Prospective Studies , Surveys and Questionnaires , United StatesABSTRACT
The ability of the Individual Placement and Support (IPS) and the Quality of Supported Employment Implementation Scale (QSEIS) fidelity scales to predict independently rated SE adherence and percentage of clients closed by the Office of Vocational Rehabilitation (OVR) was tested at 23 SE sites. QSEIS Total score (r = .47), Integration subscale (r = .53), and Support subscales (r = .61) correlated with SE adherence. Total QSEIS score also predicted OVR closure rate (r = .42). Correlations between IPS (sub)scale scores and the criterion measures were non-significant. The results support QSEIS validity and provide evidence that fidelity to the SE model is associated with better employment outcomes.
