Cognitive and symptom predictors of work outcomes for clients with schizophrenia in supported employment.
OBJECTIVE
This study examined the relationships of measures of cognitive functioning and psychiatric symptoms with work outcomes and use of vocational services for clients with schizophrenia in a supported employment program.


METHODS
Thirty clients who were newly enrolled in a supported employment program were evaluated with cognitive and symptom measures at program entry and two years later. The clients' amounts of competitive work, wages earned, on-job support, and contact with employment specialists during the two-year follow-up period were documented.


RESULTS
Predictors of clients' work outcomes included previous work history, amount of government entitlement income received, severity of negative symptoms, involvement in sheltered work activity at baseline, and level of cognitive functioning, including scores on measures of executive functioning and verbal learning and memory. The amounts of on-job support and contact with employment specialists were predicted by the cognitive domains of executive functioning, verbal learning, attention, and psychomotor speed as well as by the severity of psychotic symptoms.


CONCLUSIONS
Clients with schizophrenia who have higher levels of cognitive impairment may require greater amounts of vocational support than those with lower levels of impairment. A variety of rehabilitation strategies may be required to improve vocational outcomes and reduce the amount of supported employment services needed by clients with schizophrenia.
McGurk
Susan R
SR
Mount Sinai School of Medicine, New York, New York 10029-6574, USA. susanrmcgurk@compuserve.com
Mueser
Kim T
KT
Harvey
Phil D
PD
LaPuglia
Richard
R
Marder
Joan
J
D000328:Adult; D003071:Cognition; D016832:Employment, Supported / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011581:Psychological Tests; D011597:Psychomotor Performance; D012050:Rehabilitation, Vocational; D012456:Salaries and Fringe Benefits; D012559:Schizophrenia / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016526:Workload