Improving Work Outcome in People With Recent-onset Schizophrenia
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Interventional
Phase: Phase 4

Summary: 
      This study will determine the effectiveness of combining antipsychotic medication with
      Individual Placement and Support (IPS) and group training with the Workplace Fundamentals
      Module or Brokered Vocational Rehabilitation in facilitating the search for appropriate work
      or schooling and maintaining work or school activities in people with recent-onset
      schizophrenia.
    

Detailed description: 
      The purpose of this protocol is to test, in recent-onset schizophrenia, the efficacy of a
      rehabilitative intervention that is designed to enhance the search for appropriate work or
      schooling and to increase ability to maintain work or school activities more successfully.
      Predictors of work outcome are being assessed in the context of this work rehabilitation and
      treatment with the second-generation antipsychotic medication, risperidone.

      The Developmental Processes in Schizophrenic Disorders project involves an ongoing series of
      longitudinal follow-through studies of individuals with a recent onset of schizophrenia. The
      current protocol focuses particularly on processes affecting work outcome in this initial
      period after onset of schizophrenia, drawing on findings that link cognitive deficits in
      schizophrenia to functional outcome. The protocol is determining the effects on work outcome
      of a rehabilitative intervention designed to enhance search for appropriate work or schooling
      and to increase ability to maintain work or school activities more successfully. All entering
      patients are placed on a common antipsychotic medication, oral risperidone, and are provided
      clinical treatment by a psychiatrist and a case manager. Participating patients are randomly
      assigned to a combination of Individual Placement and Support (IPS) and group training with
      the Workplace Fundamentals Module or to a Brokered Vocational Rehabilitation Model.

      The protocol is examining the predictors of level of work functioning attained in the context
      of the work-focused intervention and maintenance on risperidone. Potential neurocognitive and
      environmental predictors of work and social functioning and clinical course are being
      examined. Aspects of early perceptual processing, allocation of attention, working memory,
      secondary verbal memory, and conceptual flexibility that are implicated as influences on
      functional outcome are assessed, as are potential stresses and supportive influences in the
      environment.
    

Intervention name(s): Individual Placement and Support; Workplace Fundamentals Module; Brokered Vocational Rehabilitation; Oral risperidone; Skills training group
Intervention type(s): Behavioral; Behavioral; Behavioral; Drug; Behavioral
Intervention description(s): Supported education/employment; Group skills training on job/school topics; Vocational rehabilitation through traditional separate state-funded agency; Risperidone, starting target dosage was 6 mg, adjusted to level judged optimal by treating psychiatrist; Group social skills training that did not focus primarily on work situations
Other intervention name(s): Risperdal
Intervention MeSH terms: Risperidone
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: work outcome; supported employment; social skills training; risperidone; cognition; first-episode schizophrenia