Comparison of focused cognitive training and portable "brain-games" on functional outcomes for vocational rehabilitation participants.

ABSTRACT: Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR?+?CG attained employment more rapidly during training. A significant time by condition interaction favored VR?+?CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR?+?CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR?+?CG. Results indicate that VR?+?CR had significantly greater effect than VR?+?CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.

SUBMITTER: Bell MD 

PROVIDER: S-EPMC5789082 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other