Sheltered employment in schizophrenia is related to disorganization symptoms, processing speed and metaphor comprehension.

Abstract

The significance of cognitive functioning deficits in schizophrenia is already well acknowledged. The relationships among lower and higher order cognitive skills and symptoms, as well as their relevance to holding a paid job are relatively less researched, though. The purpose of this study was to conduct an analysis concerning these issues. This study included 62 individuals with schizophrenia, 33 of them employed in paid sheltered jobs and 29 attending occupational therapy. They were assessed with tests of cognitive functions including communication skills. Psychopathological symptoms were assessed with the PANSS. The assessed cognitive skills turned out to be interrelated as well as showed associations with positive, negative and disorganization symptoms. Furthermore, regression analysis showed that sheltered employment status is predicted by shorter reaction time, better comprehension of metaphors and lower severity of disorganization symptoms. Multiple associations among basic and higher cognitive skills provide support for the concept of a generalized cognitive dysfunction in schizophrenia. Beside psychopathology symptoms, both basic and higher cognitive skills are also independently predictive of professional functioning in schizophrenia. This suggests potential areas of cognitive rehabilitation that could affect employability.