Determinants of occupational outcome in recent-onset psychosis: The role of cognition

Abstract

Working or studying is a common goal among people with recent-onset psychosis. Cognitive deficits have been reported to influence occupational outcome, but to date few studies have evaluated if cognitive deficits independently predict occupational outcome when taking into account other important determinants, such as self-esteem, motivation, length of time absent from employment/school, job/school search behaviours, subjective cognitive complaints and psychotic symptoms. Hence, this longitudinal study aimed to evaluate the role of cognition, as well as other key factors relevant to occupational outcome, to predict occupational status six months after baseline in people with recent-onset psychosis. A total of 27 participants receiving treatment in rehabilitation programs were included in the study. Neuropsychological, psychological, clinical and occupational measures were administered at baseline, and occupational status was collected six months later. Ordinal regression indicated that working memory and length of time absent from employment/school at baseline predicted 48.1% of the variance of occupational status at six months, with both variables showing a unique significant contribution to the model. These results suggest that working memory could be integrated in comprehensive models of occupational outcome in people with recent-onset psychosis. In addition, supported employment and education programs could target cognitive deficits and length of time absent from employment/school to help these individuals to acquire a job or return to school given their strong predictive value on occupational outcome.

Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol

“…Furthermore, our results would emphasize that social embedding and social support are critical for mental health protection and that well-being during real-life social contact is linked to social resilience in individuals PD with CM (Gan et al, 2021). Given that sequelae of CM may affect the ability to engage in both attachment and therapeutic relationships (Picken, Berry, Tarrier, & Barrowclough, 2010), our review on the association between CM and social functioning in PD is therefore a major concern for therapy delivery (MaBeth, Gumley, Schwannauer, & Fisher, 2011).…”

Healthcare resource utilization and quality of life by cognitive impairment in patients with schizophrenia

“…HCRU has been shown to be associated with working memory, verbal memory, and executive function ( Hori et al, 2020 ). Working memory and verbal memory have also been directly associated with employment and independent living, respectively ( Pothier et al, 2019 ; Shamsi et al, 2011 ). Multiple aspects of cognition have been associated with QoL ( Pascal de Raykeer et al, 2019 ).…”

Advanced glycation end products and cognitive impairment in schizophrenia

“…Our findings are consistent with previous reports indicating that processing speed impairment is related to schizophrenia [ 9 – 11 ] and FEP [ 13 ]. Furthermore, two longitudinal studies revealed that processing speed is linked to subsequent functional outcomes [ 16 ], including occupational status [ 20 ]. This evidence emphasizes that processing speed deficits are a potential intervention target to obtain better functional outcomes in patients with schizophrenia.…”

“…These impairments have been observed even in first-episode psychosis (FEP) [13,14]. Furthermore, cognitive impairment is related to poor functional outcomes [15][16][17], such as occupational prognosis, in schizophrenia [15,[18][19][20]. Importantly, therapeutic interventions targeting cognitive deficits have shown great success not only in the improvement of cognitive function [21,22] but also in better functional outcomes [23], including occupational conditions [24][25][26][27].…”