정신의학적 증상과 직업수행 간 관계는 왜 모호한가? : 개관방법의 타당성 문제

The Reason Why Psychiatric Symptoms and Work Performance Is Not Clearly Related : Partially due to deficits inherent in review methods?

The relation between psychiatric symptoms and vocational performance has significant implications for main issues in psychiatric rehabilitation including disability-identification, disability policy, focus of rehabilitation intervention, comparison and prediction of rehabilitation outcomes, and mechanisms underlying rehabilitation success. Review study results as intended to clarify it, however, are inconclusive. Whereas Anthony & Jansen(1984) concluded that little relation was there, Tsang, Lam, Ng, & Leung(2000) reached more positive conclusion. This study assumed that inconsistent results may be due to deficits inherent in traditional review methods relying on reviewer s subjective impressions and vote-counting. Reviewer s judgment may be vulnerable to subjective bias. Vote-counting strategy may lead to high Type Ⅱ error and to different conclusions depending on sample sizes of individual studies because it is based on statistical significance influenced by individual study sample size. This study attempted to integrate primary studies of Anthony et al.(1984) and Tsang et al.(2000) using quantitative review method(meta-analysis) compensating for deficits in traditional qualitative review methods. Overall mean effect size gained from Anthony et al.(1984) was small but statistically significant. which supported vote-counting s vulnerability to Type Ⅱ error. Moreover, two of overall mean effect sizes obtained from the two review studies were statistically significant and almost the same, which means Anthony s conclusion was conservatively biased. The findings suggested a need for meta-analysis on the whole literature dealing with the relation between psychiatric symptoms and vocational performance. Other potential moderators, being able to attenuate their relation and testifiable through meta-analytic method were also discussed.