title: Neuropsychological factors related to returning to work in patients with higher brain dysfunction.
abstract: We conducted neuropsychological tests of patients with higher brain dysfunction to examine the characteristics of barriers to employment.
  
  
  METHODS
  We tested 92 patients with higher brain dysfunction (average age of 36.3 +/- 13.8 years old, ranging between 16 and 63 years old, with an average post-injury period of 35.6 +/- 67.8 months) who were hospitalized at the university hospital between February 2002 and June 2007 for further neuropsychological evaluation, conducting the Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wechsler Memory Scale-Revised (WMS-R), the Rivermead Behavioral Memory Test (RBMT), Frontal Assessment Battery (FAB) and Behavioral Assessment of Dysexecutive Syndrome (BADS). The outcomes after discharge were classified between competitive employment, sheltered employment and non-employment, and the three groups were compared using one-way analysis of variance and the Scheffe test. The WAIS-R subtests were mutually compared based on the standard values of significant differences described in the WAIS-R manual. Verbal performance and full scale Intelligence Quotient (IQ) of WAIS-R were 87.7 +/- 15.6 (mean +/- standard deviation), 78.5 +/- 18.1 and 81.0 +/- 17.2, respectively, and verbal memory, visual memory, general memory, attention/concentration and delayed recall were 74.6 +/- 20.0, 76.6 +/- 21.4, 72.0 +/- 20.4, 89.0 +/- 16.5 and 65.2 +/- 20.8, respectively. The competitive employment group showed significantly higher scores in performance IQ and full IQ on the WAIS-R and verbal memory, visual memory, general memory and delayed recall on the WMS-R and RBMT than the non-employment group. The sheltered employment group showed a significantly higher score in delayed recall than the non-employment group. No difference was observed in the FAB or BADS between the three groups. In the subtests of the WAIS-R, the score for Digit Symbol-Coding was significantly lower than almost all the other subtests. For patients with higher brain dysfunction, IQ (full scale IQ > 53.2) and memory (general memory > 74.1) are important indicators in returning to work under the conditions of competitive employment.
authors.affiliation: Department of Rehabilitation, University Hospital of Occupational and Environmental Health, Japan, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kai
authors.forename: Manabu
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Okazaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Hachisuka
mesh_terms: D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000523:psychology* / Q000534:rehabilitation*; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D004651:Employment; D006801:Humans; D007360:Intelligence; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D014937:Work; D055815:Young Adult