Effects of IPS plus cognitive remediation in early psychosis: 18-month functioning outcomes of a randomized controlled trial
| Autor: | Hans de Kroon, Jaap van Weeghel, Daniëlle van Duin, Lars de Winter, Wim Veling |
|---|---|
| Přispěvatelé: | Clinical Cognitive Neuropsychiatry Research Program (CCNP), Tranzo, Scientific center for care and wellbeing, Geestelijke Gezondheidszorg |
| Rok vydání: | 2021 |
| Předmět: |
Employment
Psychosis medicine.medical_specialty Add-on law.invention Cognition Randomized controlled trial PEOPLE law Employment Supported Intervention (counseling) SCHIZOPHRENIA Humans Medicine Cognitive Dysfunction 1ST-EPISODE PSYCHOSIS Cognitive skill Biological Psychiatry 1ST EPISODE PSYCHOSIS Individual placement and support First episode business.industry SEVERE MENTAL-ILLNESS Rehabilitation Vocational IMPLEMENTING SUPPORTED EMPLOYMENT medicine.disease Mental health Psychiatry and Mental health NEGATIVE SYNDROME SCALE PSYCHOMETRIC PROPERTIES VOCATIONAL-REHABILITATION Psychotic Disorders Cognitive remediation therapy Early psychosis Physical therapy Cognitive remediation INDIVIDUAL PLACEMENT business RCT |
| Zdroj: | Schizophrenia Research, 236, 115-122. ELSEVIER SCIENCE BV Schizophrenia Research, 236, 115-122. Elsevier |
| ISSN: | 0920-9964 |
| Popis: | Background:After a first episode of psychosis, cognitive impairments present an important barrier to successful (re-)entry into work and education. We assessed whether cognitive remediation (CR) as an add-on to Individual Placement and Support (IPS) can improve participation in regular employment and education.Method:Participants with early psychosis (N = 73) were randomly assigned to receive IPS supplemented with computerized CR, or IPS plus an active control intervention (computer games). The primary outcome was the number of hours spent in competitive employment or regular education, which was assessed every month during the 18-month study period. Secondary outcomes included employment rate, cognitive functioning, mental health (assessed at baseline, 6 and 18 months), and job duration (assessed after 18 months). Both patients and assessors were blind to treatment.Results:Participants receiving IPS + CR showed greater improvement of competitive employment over time in terms of hours worked (during follow-up period: 38.5 vs. 19.6 h, B = 2.94; Wald χ2 = 5.39; P = .02) and employment rate (at T2: 62.1% vs. 25.9%, χ 2 = 7.39; df = 1; P = .008), compared with the IPS + control group, particularly in the longer term. The number of hours spent in regular education was lower in the IPS + CR group, with more participants having ended education for a positive reason. There was a significant beneficial effect of adjunctive CR for executive functioning, subjective cognitive functioning, and empowerment.Conclusions:Augmenting IPS with CR has a significant impact on competitive employment in people with early psychosis, with beneficial effects being more pronounced after 18 months. |
| Databáze: | OpenAIRE |
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