Effects of IPS plus cognitive remediation in early psychosis: 18-month functioning outcomes of a randomized controlled trial
Van Duin,Daniëlle De Winter,Lars Kroon,Hans Veling,Wim Van Weeghel,Jaap
Van Duin,Daniëlle
De Winter,Lars
Kroon,Hans
Veling,Wim
Van Weeghel,Jaap
Abstract
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.
Description
Funding Information: This work was supported by the Ministry of Social Affairs and Employment Opportunities in The Netherlands (grant number 3165 ).
Date
2021
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Research Projects
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Keywords
1ST EPISODE PSYCHOSIS, 1ST-EPISODE PSYCHOSIS, Add-on, Cognitive remediation, Early psychosis, IMPLEMENTING SUPPORTED EMPLOYMENT, INDIVIDUAL PLACEMENT, Individual placement and support, NEGATIVE SYNDROME SCALE, PEOPLE, PSYCHOMETRIC PROPERTIES, RCT, SCHIZOPHRENIA, SEVERE MENTAL-ILLNESS, VOCATIONAL-REHABILITATION
Citation
Van Duin, D, De Winter, L, Kroon, H, Veling, W & Van Weeghel, J 2021, 'Effects of IPS plus cognitive remediation in early psychosis : 18-month functioning outcomes of a randomized controlled trial', Schizophrenia Research, vol. 236, pp. 115-122. https://doi.org/10.1016/j.schres.2021.07.025