Predicting Individual Placement and Support (IPS) outcome using Cognition and Clinical symptoms in Recent-onset Psychosis

Abstract

A psychosis significantly declines the ability to obtain/maintain employment. Individual Placement and Support (IPS) focuses on vocational rehabilitation, but 40 to 55% of patients still are not successful in finding employment. Research conducted to find possible modifiable factors largely found neuropsychological performance and negative symptoms related to vocational outcome, but did not examine these variables in IPS alone or included educational outcome. The current study examines the relationship and predictive value of cognition and clinical symptoms in IPS outcome among patients with a recent onset of psychosis.

Thirty-one patients completed a neuropsychological test battery followed by the administration of the PANSS. At 3, 6 and 12 months following baseline hours worked or spend on education were collected. Pearson’s correlations and Kendall’s tau showed working memory related to total hours at 3 months, positive symptoms to 6 months and positive symptoms and total PANSS score to 12 months. Hierarchical multiple regression analyses showed positive symptoms being the only significant predicator of total hours at 6 months and total PANSS score mediating the relationship between positive symptoms and total hours at 12 months.

In conclusion, the current study found almost no relationship between cognition and IPS outcome, while severity of general psychopathology predicated IPS outcome in the long-term. These findings indicate that more research needs to be done to examine the predictive value of general severity of symptoms aside from specific symptom clusters. Because of the differences in findings between studies, further research is needed to carefully examine possible modifiable factors that influence IPS outcome and should include educational outcome.