Cognitive Impairment, Symptoms, Social Functioning, and Vocational Rehabilitation in Schizophrenia

Abstract

This study evaluated whether cognitive impairment, negative symptoms, positive symptoms (all measured with the Positive and Negative Syndrome Scale), and social adjustment (measured with the Social Adjustment Scale) predicted work outcomes over two years in 134 unemployed patients with schizophrenia or schizoaffective disorder who were randomly assigned to participate in one of three vocational rehabilitation programs: Individual Placement and Support (IPS, a supported employment model), psychiatric rehabilitation center (PSR), and standard services (Standard). Cognitive impairment predicted worse outcomes (hours worked and wags) in the PSR group, and negative symptoms predicted work outcomes for both the PSR and the IPS programs. There were no predictors of work outcome in the Standard group. The results suggest that cognitive impairments may interfere with response to social learning-based interventions, but not responses to supported employment.