Cognitive functioning and employment among people with schizophrenia in vocational rehabilitation

BACKGROUND: Employment is central to recovery in schizophrenia, but little attention has been paid to its relationship with cognitive functioning. OBJECTIVE: This cross-sectional study adds to the knowledge base of relationships between cognitive functioning and gaining competitive employment, work hours per week, and monthly income among people with schizophrenia in vocational rehabilitation. It also examines which area of cognitive function may be decisive for gaining employment. METHODS: Thirty-nine vocational rehabilitation participants were administered a cognitive battery based on MATRICS Consensus Cognitive Battery. Socio-demographic, clinical, and vocational data were gathered and analyzed with nonparametric statistics. RESULTS: Individuals with competitive employment differed from those without competitive employment in attention and psychomotor speed, delayed verbal recall, immediate visual recall, and planning, reasoning, and problem-solving. Higher scores in immediate and delayed verbal recall and planning, reasoning, and problem-solving correlated with more work hours per week and higher income. Immediate visual recall was related to higher income. Higher scores in planning, reasoning, and problem-solving was an indicator of competitive employment (OR = 1.48). CONCLUSIONS: Higher order cognitive functioning of planning, reasoning, and problem-solving may have a central role in gaining employment. The findings should be considered in compensation for or improving cognitive functions for vocational rehabilitation participants.