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03-03-2011 | Mental health | Article

Vocational rehabilitation benefits schizophrenia patients

Abstract

Free abstract

MedWire News: Vocational rehabilitation improves cognition and reduces symptoms in patients with schizophrenia, say Brazilian researchers.

"Recent studies estimate that approximately 80% of the patients with schizophrenia present a significant cognitive deficit when compared to healthy persons, and this deficit may affect up to 98% of patients when premorbid functioning is considered," observe Danielle Soares Bio and Wagner Farid Gattaz from the University of São Paulo.

They explain that a number of studies have shown a positive association between current work status and cognitive performance in schizophrenia patients, but few have investigated whether vocational interventions improve performance.

To address this, the researchers recruited 112 patients with schizophrenia, aged an average of 29 years, who had been clinically stable for at least 6 months and who expressed an interest in vocational rehabilitation.

Of these, 57 were placed on a 6-month vocational rehabilitation program and the remaining 55 (controls) were placed on a waiting list for the program.

The vocational program consisted of an internship in one of 42 companies. Patients were allocated to various employers based on their own choices and prior experience in the respective business areas. Patients signed a working contract and received enough money to cover their costs for transportation and food.

All of the participants were assessed at baseline and after 6 months using the Positive and Negative Syndrome Scale (PANSS) and the Quality of Life Questionnaire (QLQ).

They also underwent comprehensive neuropsychological evaluation at both timepoints using the Wechsler Adult Intelligence Scale-III (WAIS-III), the Stroop Color-Word Test, and the Wisconsin Card Sorting Test.

The researchers found that patients in the vocational group had a significantly greater mean improvement in scores on the comprehension subtest of the WAIS-III, from 12.8 to 15.1, compared with controls, from 14.2 to 14.5, over the study period.

Patients in the vocational group also had significantly greater improvements in scores on the card III subtest of the Stroop Color-Word Test, and the items "categories" and "non-perseverative errors" on the Wisconsin Card Sorting Test compared with controls.

Furthermore, vocational patients had greater reductions in PANSS total scores, from 49.7 at baseline to 44.6 after 6 months, compared with controls, from 53.7 to 52.8, as well as greater improvement in QLQ scores, from 72.4 to 80.7 compared with from 65.8 to 69.2, respectively.

Bio and Gattaz conclude in the journal Schizophrenia Research: "Together with results from the literature, our findings reinforce the notion that the inclusion of vocational interventions may enhance the effectiveness of therapeutic strategies for schizophrenia patients."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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