[Vocational therapy in schizophrenia: effects only with some patients and with which patients?].

Objectives: 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.
Methods: 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.
Results: 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.
Conclusion: Targeted and more appropriate design of vocational therapy seems necessary.