Augmenting supported employment with cognitive remediation can improve vocational outcomes for schizophrenia patients with lower levels of community functioning, according to the study “Benefits of Cognitive Remediation and Supported Employment for Schizophrenia Patients With Poor Community Functioning,” just published in Psychiatric Services in Advance. However, cognitive remediation—comprising various kinds of “brain training” computer software—may not be necessary for schizophrenia patients functioning better in their communities, according to the report.
Researchers from Yale University School of Medicine analyzed data from two related randomized controlled trials. A total of 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 quality-of-life scores at baseline. Primary outcome measures were competitive employment rates and total hours of work.
Supported employment entailed individual placement and support provided by a community mental health center and weekly support groups for discussion of work-related issues. Cognitive remediation in the augmented group included two kinds of brain-training software tailored for people with compromised brain function.
Researchers found that employment rates over two years for participants with lower functioning were significantly different for the two conditions (20% for supported employment and 49% for remediation),while participants with higher functioning showed equivalent rates of employment (62% and 54%). 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.