OBJECTIVE: This study was conducted to determine whether augmenting supported employment with cognitive remediation can improve vocational outcomes and whether augmentation is more important for participants with lower community functioning. METHODS: In this secondary analysis of data from two related, single-blind, randomized controlled trials, 175 participants with schizophrenia or schizoaffective disorder receivedsupported employment or supported employment plus cognitive remediation and were classified into higher or lower community functioning according to a median split of their quality-of-life scores at baseline. Participants received one year of active intervention and follow-up a year later. Primary outcome measures were competitive employment rates and total hours of work. RESULTS:Employment rates over two years for participants with lower community functioning were significantly different for the two conditions (supported employment=20%, plus cognitive remediation=49%, p<.005), whereas participants with higher functioning showed equivalent rates of employment (62% versus 54%, ns). Among lower-functioning participants, those who received cognitive remediation also worked significantly more hours over two years than those who received supported employment only, but higher-functioning participants worked similar amounts of hours in both conditions. Improvements in cognitive functioning and intrinsic motivation were related to employment outcomes but only for the lower-functioning group in the supported employment plus cognitive remediation condition, suggesting possible mechanisms for the observed effects. CONCLUSIONS: Augmenting supported employment with cognitive remediation may boost vocational outcomes for participants with lower community functioning but may not be necessary for those functioning better in their communities.
RCT Entities:
OBJECTIVE: This study was conducted to determine whether augmenting supported employment with cognitive remediation can improve vocational outcomes and whether augmentation is more important for participants with lower community functioning. METHODS: In this secondary analysis of data from two related, single-blind, randomized controlled trials, 175 participants with schizophrenia or schizoaffective disorder received supported employment or supported employment plus cognitive remediation and were classified into higher or lower community functioning according to a median split of their quality-of-life scores at baseline. Participants received one year of active intervention and follow-up a year later. Primary outcome measures were competitive employment rates and total hours of work. RESULTS: Employment rates over two years for participants with lower community functioning were significantly different for the two conditions (supported employment=20%, plus cognitive remediation=49%, p<.005), whereas participants with higher functioning showed equivalent rates of employment (62% versus 54%, ns). Among lower-functioning participants, those who received cognitive remediation also worked significantly more hours over two years than those who received supported employment only, but higher-functioning participants worked similar amounts of hours in both conditions. Improvements in cognitive functioning and intrinsic motivation were related to employment outcomes but only for the lower-functioning group in the supported employment plus cognitive remediation condition, suggesting possible mechanisms for the observed effects. CONCLUSIONS: Augmenting supported employment with cognitive remediation may boost vocational outcomes for participants with lower community functioning but may not be necessary for those functioning better in their communities.
Authors: Raeanne C Moore; Alexandrea L Harmell; Philip D Harvey; Christopher R Bowie; Colin A Depp; Ann E Pulver; John A McGrath; Thomas L Patterson; Veronica Cardenas; Paula Wolyniec; Mary H Thornquist; James R Luke; Barton W Palmer; Dilip V Jeste; Brent T Mausbach Journal: Schizophr Res Date: 2015-10-01 Impact factor: 4.939
Authors: William P Horan; L Felice Reddy; Deanna M Barch; Robert W Buchanan; Eduardo Dunayevich; James M Gold; Steven R Marder; Jonathan K Wynn; Jared W Young; Michael F Green Journal: Schizophr Bull Date: 2015-07-23 Impact factor: 9.306
Authors: Yvonne B Suijkerbuijk; Frederieke G Schaafsma; Joost C van Mechelen; Anneli Ojajärvi; Marc Corbière; Johannes R Anema Journal: Cochrane Database Syst Rev Date: 2017-09-12