title: Cognitive remediation and occupational outcome in schizophrenia spectrum disorders: A 2year follow-up study.
abstract: Neurocognitive impairment is prominent in schizophrenia and a significant predictor of poor occupational outcomes. Vocational rehabilitation (VR) is frequently implemented to counteract high unemployment rates. Individuals with schizophrenia however face numerous challenges such as neurocognitive impairments and psychotic symptoms. Hence, augmenting VR to address illness-related factors may optimize occupational outcomes. The aim of this study was to examine the effects of Cognitive Remediation (CR) combined with VR(CR+VR) compared to techniques from Cognitive Behavioral Therapy (CBT) combined with VR(CBT+VR) on neurocognition and occupational functioning over a 2year period. A total of 131participants underwent assessment with the MATRICS Consensus Cognitive Battery (MCCB) at baseline, post treatment (after 10months) and follow-up (2years after randomization). Occupational status and number of hours worked were recorded at all assessment points. Both groups improved on several neurocognitive domains. All improvements were however in favor of the CR group. There was a significant increase in number of participants working and hours worked in both groups throughout the project period, with no between-group differences. Number of hours worked at follow-up was predicted by change in Working Memory and the Composite Score in the CR group. CR-augmented VR improved several domains, particularly Verbal Learning and Working Memory, which were central in the CR program. The combination of VR and CR or CBT thus enabled a significant proportion of participants to attain and maintain work.
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway. Electronic address: June.Lystad@medisin.uio.no.
authors.forename: June Ullevoldsæter
authors.initials: JU
authors.lastname: Lystad
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Falkum
authors.affiliation: Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway; Department of Psychiatry, Sørlandet Hospital Trust, Service Box 416, 4604 Kristiansand, Norway.
authors.forename: Vegard Øksendal
authors.initials: VØ
authors.lastname: Haaland
authors.affiliation: Institute of Clinical Medicine, University of Oslo, Postboks 1039 Blindern, 0315 Oslo, Norway.
authors.forename: Helen
authors.initials: H
authors.lastname: Bull
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway.
authors.forename: Stig
authors.initials: S
authors.lastname: Evensen
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University, Boston, MA, United States.
authors.forename: Susan R
authors.initials: SR
authors.lastname: McGurk
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Postboks 4959 Nydalen, 0424 Oslo, Norway; Research Unit of Neuropsychopathology, Department of Psychology, University of Oslo, Postboks 1094 Blindern, 0317 Oslo, Norway.
authors.forename: Torill
authors.initials: T
authors.lastname: Ueland
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D009664:Norway; D009788:Occupational Therapy / Q000379:methods*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
keywords: Cognitive behavioral therapy; Cognitive remediation; MCCB; Neurocognition; Vocational rehabilitation