Cognitive remediation and work outcomes in schizophrenia
Main Article Content
Abstract
Getting and keeping a job are some of the main criteria for recovery in schizophrenia, and are often undermined by cognitive impairments. Cognitive performance is clearly associated with functional outcomes, particularly with the ability to get a job. Reducing the impact of cognitive disorders is therefore necessary to help patients with schizophrenia succeed in their professional integration or reintegration.
Cognitive remediation is the therapeutic tool used to best fight cognitive impairments, by training the impaired functions or trying to reduce their functional outcomes through the development of cognitive strategies. This article reviews the recent literature focused on the vocational outcomes of cognitive remediation when used in association with employment support, and offers to refine its indications depending on specific parameters.
Article Details
How to Cite
FRANCK, Nicolas; DUBRULLE, Aurélie.
Cognitive remediation and work outcomes in schizophrenia.
Medical Research Archives, [S.l.], n. 3, july 2016.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/544>. Date accessed: 27 dec. 2024.
Keywords
schizophrenia; recovery; cognitive deficits; executive functions; memory; attention; neuropsychology; social cognition; metacognition; cognitive remediation; vocational outcomes; work functioning; competitive employment; vocational rehabilitation.
Issue
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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Au, D. W. H., Tsang, H. W. H., So, W. W. Y., Bell, M. D., Cheung, V., Yiu, M. G. C., Tam, K. L., and Lee, G. T. (2015). Effects of integrated supported employment plus cognitive remediation training for people with schizophrenia and schizoaffective disorders. Schizophrenia Research, 166(1–3), 297–303.
Bell, M., Bryson, G., Greig, T., Corcoran, C., and Wexler, B. E. (2001). Neurocognitive enhancement therapy with work therapy: effects on neuropsychological test performance. Archives of General Psychiatry, 58(8), 763–768.
Bell, M. D., Choi, K.-H., Dyer, C., and Wexler, B. E. (2014). Benefits of cognitive remediation and supported employment for schizophrenia patients with poor community functioning. Psychiatric Services (Washington, D.C.), 65(4), 469–475.
Bell, M. D., Zito, W., Greig, T., and Wexler, B. E. (2008). Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophrenia Research, 105(1–3), 18–29.
Bergh, S., Hjorthøj, C., Sørensen, H. J., Fagerlund, B., Austin, S., Secher, R. G., Jepsen, J. R., and Nordentoft, M. (2016). Predictors and longitudinal course of cognitive functioning in schizophrenia spectrum disorders, 10years after baseline: The OPUS study. Schizophrenia Research.
Bond, G. R., Drake, R. E., and Becker, D. R. (2008). An update on randomized controlled trials of evidence-based supported employment. Psychiatric Rehabilitation Journal, 31(4), 280–290.
Bond, G. R., Drake, R. E., and Becker, D. R. (2012). Generalizability of the Individual Placement and Support (IPS) model of supported employment outside the US. World psychiatry: official journal of the World Psychiatric Association (WPA), 11(1), 32–39.
Bowie, C. R., Depp, C., McGrath, J. A., Wolyniec, P., Mausbach, B. T., Thornquist, M. H., Luke, J., Patterson, T. L., Harvey, P. D., and Pulver, A. E. (2010). Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. The American Journal of Psychiatry, 167(9), 1116–1124.
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Choi, K.-H., Fiszdon, J. M., and Bell, M. D. (2013). Beyond cognition: a longitudinal investigation of the role of motivation during a vocational rehabilitation program. The Journal of Nervous and Mental Disease, 201(3), 173–178.
Christensen, T. N., Nielsen, I. G., Stenager, E., Morthorst, B. R., Lindschou, J., Nordentoft, M., and Eplov, L. F. (2015). Individual Placement and Support supplemented with cognitive remediation and work-related social skills training in Denmark: study protocol for a randomized controlled trial. Trials, 16, 280.
Contreras, N., Rossell, S. L., Castle, D. J., Fossey, E., Morgan, D., Crosse, C., and Harvey, C. (2012). Enhancing work-focused supports for people with severe mental illnesses in australia. Rehabilitation Research and Practice, 2012, 863203.
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Franck, N. et al. (2103b) Cognitive Remediation and Sheltered Employment in Schizophrenia (RemedRehab) https://clinicaltrials.gov/ct2/show/NCT01891929
Franck, N. (2014). Cognitive remediation and work outcome in schizophrenia. L’Encéphale, 40 Suppl 2, S75-80.
Greig, T. C., Zito, W., Wexler, B. E., Fiszdon, J., and Bell, M. D. (2007). Improved Cognitive Function in Schizophrenia After One Year of Cognitive Training and Vocational Services. Schizophrenia research, 96(1–3), 156–161.
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Kurtz, M. M. (2012). Cognitive remediation for schizophrenia: current status, biological correlates and predictors of response. Expert Review of Neurotherapeutics, 12(7), 813–821.
Lecomte, T., Corbière, M., Simard, S., and Leclerc, C. (2014). Merging evidence-based psychosocial interventions in schizophrenia. Behavioral Sciences (Basel, Switzerland), 4(4), 437–447.
Lee, W. K. (2013). Effectiveness of computerized cognitive rehabilitation training on symptomatological, neuropsychological and work function in patients with schizophrenia. Asia-Pacific Psychiatry: Official Journal of the Pacific Rim College of Psychiatrists, 5(2), 90–100.
Lehman, A. F., Goldberg, R., Dixon, L. B., McNary, S., Postrado, L., Hackman, A., and McDonnell, K. (2002). Improving employment outcomes for persons with severe mental illnesses. Archives of General Psychiatry, 59(2), 165–172.
Lystad, J. U., Falkum, E., Haaland, V. Ø., Bull, H., Evensen, S., Bell, M. D., and Ueland, T. (2016a). Neurocognition and occupational functioning in schizophrenia spectrum disorders: The MATRICS Consensus Cognitive Battery (MCCB) and workplace assessments. Schizophrenia Research, 170(1), 143–149.
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Au, D. W. H., Tsang, H. W. H., So, W. W. Y., Bell, M. D., Cheung, V., Yiu, M. G. C., Tam, K. L., and Lee, G. T. (2015). Effects of integrated supported employment plus cognitive remediation training for people with schizophrenia and schizoaffective disorders. Schizophrenia Research, 166(1–3), 297–303.
Bell, M., Bryson, G., Greig, T., Corcoran, C., and Wexler, B. E. (2001). Neurocognitive enhancement therapy with work therapy: effects on neuropsychological test performance. Archives of General Psychiatry, 58(8), 763–768.
Bell, M. D., Choi, K.-H., Dyer, C., and Wexler, B. E. (2014). Benefits of cognitive remediation and supported employment for schizophrenia patients with poor community functioning. Psychiatric Services (Washington, D.C.), 65(4), 469–475.
Bell, M. D., Zito, W., Greig, T., and Wexler, B. E. (2008). Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophrenia Research, 105(1–3), 18–29.
Bergh, S., Hjorthøj, C., Sørensen, H. J., Fagerlund, B., Austin, S., Secher, R. G., Jepsen, J. R., and Nordentoft, M. (2016). Predictors and longitudinal course of cognitive functioning in schizophrenia spectrum disorders, 10years after baseline: The OPUS study. Schizophrenia Research.
Bond, G. R., Drake, R. E., and Becker, D. R. (2008). An update on randomized controlled trials of evidence-based supported employment. Psychiatric Rehabilitation Journal, 31(4), 280–290.
Bond, G. R., Drake, R. E., and Becker, D. R. (2012). Generalizability of the Individual Placement and Support (IPS) model of supported employment outside the US. World psychiatry: official journal of the World Psychiatric Association (WPA), 11(1), 32–39.
Bowie, C. R., Depp, C., McGrath, J. A., Wolyniec, P., Mausbach, B. T., Thornquist, M. H., Luke, J., Patterson, T. L., Harvey, P. D., and Pulver, A. E. (2010). Prediction of real-world functional disability in chronic mental disorders: a comparison of schizophrenia and bipolar disorder. The American Journal of Psychiatry, 167(9), 1116–1124.
Boycott, N., Schneider, J., and McMurran, M. (2012). Additional interventions to enhance the effectiveness of individual placement and support: a rapid evidence assessment. Rehabilitation Research and Practice, 2012, 382420.
Bracy, O. (1995). CogReHab Software. Psychological Software Services, Indianapolis, Indiana. Scientific Learning. (2003). www.Hypomania.Scilearn.Com/alp.
Chan, J. Y. C., Hirai, H. W., and Tsoi, K. K. F. (2015). Can computer-assisted cognitive remediation improve employment and productivity outcomes of patients with severe mental illness? A meta-analysis of prospective controlled trials. Journal of Psychiatric Research, 68, 293–300.
Chang, W. C., Man Tang, J. Y., Ming Hui, C. L., Wa Chan, S. K., Ming Lee, E. H., and Hai Chen, E. Y. (2014). Clinical and cognitive predictors of vocational outcome in first-episode schizophrenia: a prospective 3 year follow-up study. Psychiatry Research, 220(3), 834–839.
Choi, K.-H., Fiszdon, J. M., and Bell, M. D. (2013). Beyond cognition: a longitudinal investigation of the role of motivation during a vocational rehabilitation program. The Journal of Nervous and Mental Disease, 201(3), 173–178.
Christensen, T. N., Nielsen, I. G., Stenager, E., Morthorst, B. R., Lindschou, J., Nordentoft, M., and Eplov, L. F. (2015). Individual Placement and Support supplemented with cognitive remediation and work-related social skills training in Denmark: study protocol for a randomized controlled trial. Trials, 16, 280.
Contreras, N., Rossell, S. L., Castle, D. J., Fossey, E., Morgan, D., Crosse, C., and Harvey, C. (2012). Enhancing work-focused supports for people with severe mental illnesses in australia. Rehabilitation Research and Practice, 2012, 863203.
Demily, C., and Franck, N. (2008). Cognitive remediation: a promising tool for the treatment of schizophrenia. Expert Review of Neurotherapeutics, 8(7), 1029–1036.
Franck, N., Duboc, C., Sundby, C., Amado, I., Wykes, T., Demily, C., Launay, C., Le Roy, V., Bloch, P., Willard, D., Todd, A., Petitjean, F., Foullu, S., Briant, P., Grillon, M.-L., Deppen, P., Verdoux, H., Bralet, M.-C., Januel, D., Riche, B., Roy, P., Members of Cognitive Remediation Network, and Vianin, P. (2013a). Specific vs general cognitive remediation for executive functioning in schizophrenia: a multicenter randomized trial. Schizophrenia Research, 147(1), 68–74.
Franck, N. et al. (2103b) Cognitive Remediation and Sheltered Employment in Schizophrenia (RemedRehab) https://clinicaltrials.gov/ct2/show/NCT01891929
Franck, N. (2014). Cognitive remediation and work outcome in schizophrenia. L’Encéphale, 40 Suppl 2, S75-80.
Greig, T. C., Zito, W., Wexler, B. E., Fiszdon, J., and Bell, M. D. (2007). Improved Cognitive Function in Schizophrenia After One Year of Cognitive Training and Vocational Services. Schizophrenia research, 96(1–3), 156–161.
Harvey, P. D., Green, M. F., Keefe, R. S. E., and Velligan, D. I. (2004). Cognitive functioning in schizophrenia: a consensus statement on its role in the definition and evaluation of effective treatments for the illness. The Journal of Clinical Psychiatry, 65(3), 361–372.
Hogarty, G. E., Greenwald, D. P., and Eack, S. M. (2006). Special Section: A Memorial Tribute: Durability and Mechanism of Effects of Cognitive Enhancement Therapy. Psychiatric Services, 57(12), 1751–1757.
Kurtz, M. M. (2012). Cognitive remediation for schizophrenia: current status, biological correlates and predictors of response. Expert Review of Neurotherapeutics, 12(7), 813–821.
Lecomte, T., Corbière, M., Simard, S., and Leclerc, C. (2014). Merging evidence-based psychosocial interventions in schizophrenia. Behavioral Sciences (Basel, Switzerland), 4(4), 437–447.
Lee, W. K. (2013). Effectiveness of computerized cognitive rehabilitation training on symptomatological, neuropsychological and work function in patients with schizophrenia. Asia-Pacific Psychiatry: Official Journal of the Pacific Rim College of Psychiatrists, 5(2), 90–100.
Lehman, A. F., Goldberg, R., Dixon, L. B., McNary, S., Postrado, L., Hackman, A., and McDonnell, K. (2002). Improving employment outcomes for persons with severe mental illnesses. Archives of General Psychiatry, 59(2), 165–172.
Lystad, J. U., Falkum, E., Haaland, V. Ø., Bull, H., Evensen, S., Bell, M. D., and Ueland, T. (2016a). Neurocognition and occupational functioning in schizophrenia spectrum disorders: The MATRICS Consensus Cognitive Battery (MCCB) and workplace assessments. Schizophrenia Research, 170(1), 143–149.
Lystad, J. U., Falkum, E., Haaland, V. Ø., Bull, H., Evensen, S., Bell, M. D., and Ueland, T. (2016b). Neurocognition and occupational functioning in schizophrenia spectrum disorders: The MATRICS Consensus Cognitive Battery (MCCB) and workplace assessments. Schizophrenia Research, 170(1), 143–149.
Marwaha, S., Johnson, S., Bebbington, P., Stafford, M., Angermeyer, M. C., Brugha, T., Azorin, J.-M., Kilian, R., Hansen, K., and Toumi, M. (2007). Rates and correlates of employment in people with schizophrenia in the UK, France and Germany. The British Journal of Psychiatry: The Journal of Mental Science, 191, 30–37.
McGurk, S. R., and Mueser, K. T. (2004). Cognitive functioning, symptoms, and work in supported employment: a review and heuristic model. Schizophrenia Research, 70(2–3), 147–173.
McGurk, S. R., Mueser, K. T., DeRosa, T. J., and Wolfe, R. (2009). Work, recovery, and comorbidity in schizophrenia: a randomized controlled trial of cognitive remediation. Schizophrenia Bulletin, 35(2), 319–335.
McGurk, S. R., Mueser, K. T., Feldman, K., Wolfe, R., and Pascaris, A. (2007). Cognitive training for supported employment: 2-3 year outcomes of a randomized controlled trial. The American Journal of Psychiatry, 164(3), 437–441.
McGurk, S. R., Mueser, K. T., Xie, H., Feldman, K., Shaya, Y., Klein, L., and Wolfe, R. (2016). Cognitive remediation for vocational rehabilitation nonresponders. Schizophrenia Research.
McGurk, S. R., Mueser, K. T., Xie, H., Welsh, J., Kaiser, S., Drake, R. E., Becker, D. R., Bailey, E., Fraser, G., Wolfe, R., and McHugo, G. J. (2015). Cognitive Enhancement Treatment for People With Mental Illness Who Do Not Respond to Supported Employment: A Randomized Controlled Trial. The American Journal of Psychiatry, 172(9), 852–861.
Medalia, A., and Saperstein, A. M. (2013). Does cognitive remediation for schizophrenia improve functional outcomes? Current Opinion in Psychiatry, 26(2), 151–157.
Mueser, K. T., Deavers, F., Penn, D. L., and Cassisi, J. E. (2013). Psychosocial treatments for schizophrenia. Annual Review of Clinical Psychology, 9, 465–497.
Mueser, K. T., and McGurk, S. R. (2014a). Supported employment for persons with serious mental illness: current status and future directions. L’Encéphale, 40 Suppl 2, S45-56.
Mueser, K. T., and McGurk, S. R. (2014b). Supported employment for persons with serious mental illness: current status and future directions. L’Encéphale, 40 Suppl 2, S45-56.
Nuechterlein, K. H., Subotnik, K. L., Green, M. F., Ventura, J., Asarnow, R. F., Gitlin, M. J., Yee, C. M., Gretchen-Doorly, D., and Mintz, J. (2011). Neurocognitive predictors of work outcome in recent-onset schizophrenia. Schizophrenia Bulletin, 37 Suppl 2, S33-40.
Provencher, H. L., Gregg, R., Mead, S., and Mueser, K. T. (2002). The role of work in the recovery of persons with psychiatric disabilities. Psychiatric Rehabilitation Journal, 26(2), 132–144.
PubMed entry. (n.d.). .
Reddy, L. F., and Kern, R. S. (2014a). Supported employment among veterans with serious mental illness: the role of cognition and social cognition on work outcome. Schizophrenia Research: Cognition, 1(3), 144–148.
Reddy, L. F., Horan, W. P., Jahshan, C., and Green, M. F. (2014b). Cognitive Remediation for Schizophrenia: A Review of Recent Findings. Current Treatment Options in Psychiatry, 1(2), 121–133.
Rinaldi, M., Killackey, E., Smith, J., Shepherd, G., Singh, S. P., and Craig, T. (2010). First episode psychosis and employment: a review. International Review of Psychiatry (Abingdon, England), 22(2), 148–162.
Roder, V., Mueller, D. R., Mueser, K. T., and Brenner, H. D. (2006). Integrated psychological therapy (IPT) for schizophrenia: is it effective? Schizophrenia Bulletin, 32 Suppl 1, S81-93.
Saavedra, J., López, M., González, S., Arias, S., and Crawford, P. (2015). Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness. Community Mental Health Journal.
Saperstein, A. M., Thysen, J., and Medalia, A. (2012a). The Measure of Insight into Cognition: reliability and validity of clinician-rated and self-report scales of neurocognitive insight for schizophrenia. Schizophrenia Research, 134(1), 54–58.
Saperstein, A. M., Thysen, J., and Medalia, A. (2012b). The Measure of Insight into Cognition: reliability and validity of clinician-rated and self-report scales of neurocognitive insight for schizophrenia. Schizophrenia Research, 134(1), 54–58.
Sato, S., Iwata, K., Furukawa, S.-I., Matsuda, Y., Hatsuse, N., and Ikebuchi, E. (2013). The effects of the combination of cognitive training and supported employment on improving clinical and working outcomes for people with schizophrenia in Japan. Clinical practice and epidemiology in mental health: CP & EMH, 10, 18–27.
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