A longitudinal study of learning potential and rehabilitation outcome in schizophrenia

The study examined whether a measure of learning potential is prospectively related to the success of a vocational rehabilitation program for patients with severe mental illness in Germany.

At rehabilitation intake (November 2002 to January 2004), 41 persons with schizophrenia or schizoaffective disorders completed a test-train-test version of the Wisconsin Card Sorting Test as a measure of learning potential. Research participants were classified as high scorers, learners, or nonlearners. Rehabilitation outcome was assessed with measures of work capability during the rehabilitation program, level of functioning during rehabilitation and at three-month follow-up, and level of vocational integration at three-month follow-up.

Individual learning potential was associated with the improvement of work-related learning ability during rehabilitation and with the level of functioning and the level of vocational integration at three-month follow-up (about 15 months after the initial testing). Generally, high scorers had better rehabilitation outcome at all assessment points regarding all outcome measures. Even though learners and nonlearners started at comparable levels at the beginning of the rehabilitation, learners benefited more from the program, whereas nonlearners showed a rather unfavorable rehabilitation outcome.

Findings supported the assumption that learning potential is an informative predictor of rehabilitation outcome and may add information beyond static cognitive measures. Learning potential should be considered in the further development of vocational rehabilitation programs.