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Schizophr Res. 2017 Jul;185:122-129. doi: 10.1016/j.schres.2016.12.020. Epub 2016 Dec 29.

Cognitive remediation and occupational outcome in schizophrenia spectrum disorders: A 2year follow-up study.

Author information

1
Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway. Electronic address: June.Lystad@medisin.uio.no.
2
Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway.
3
Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway; Department of Psychiatry, Sørlandet Hospital Trust, Service Box 416, 4604 Kristiansand, Norway.
4
Institute of Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway.
5
Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
6
Center for Psychiatric Rehabilitation, Boston University, Boston, MA, United States.
7
Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Research Unit of Neuropsychopathology, Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway.

Abstract

Neurocognitive impairment is prominent in schizophrenia and a significant predictor of poor occupational outcomes. Vocational rehabilitation (VR) is frequently implemented to counteract high unemployment rates. Individuals with schizophrenia however face numerous challenges such as neurocognitive impairments and psychotic symptoms. Hence, augmenting VR to address illness-related factors may optimize occupational outcomes. The aim of this study was to examine the effects of Cognitive Remediation (CR) combined with VR(CR+VR) compared to techniques from Cognitive Behavioral Therapy (CBT) combined with VR(CBT+VR) on neurocognition and occupational functioning over a 2year period. A total of 131participants underwent assessment with the MATRICS Consensus Cognitive Battery (MCCB) at baseline, post treatment (after 10months) and follow-up (2years after randomization). Occupational status and number of hours worked were recorded at all assessment points. Both groups improved on several neurocognitive domains. All improvements were however in favor of the CR group. There was a significant increase in number of participants working and hours worked in both groups throughout the project period, with no between-group differences. Number of hours worked at follow-up was predicted by change in Working Memory and the Composite Score in the CR group. CR-augmented VR improved several domains, particularly Verbal Learning and Working Memory, which were central in the CR program. The combination of VR and CR or CBT thus enabled a significant proportion of participants to attain and maintain work.

KEYWORDS:

Cognitive behavioral therapy; Cognitive remediation; MCCB; Neurocognition; Vocational rehabilitation

PMID:
28041917
DOI:
10.1016/j.schres.2016.12.020
[Indexed for MEDLINE]

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