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. 2025 May 7;4(2):e70117.
doi: 10.1002/pcn5.70117. eCollection 2025 Jun.

Impact of negative symptom reduction on employment and vocational activity outcomes following cognitive remediation therapy in schizophrenia: A 1-year follow-up study

Yasuhisa Nakamura  1 , Keito Shimada  2 , Reiko Miyamoto  3 , Akihiro Koreki  4 , Sachiko Anamizu  5 , Masaru Mimura  4
Affiliations

Impact of negative symptom reduction on employment and vocational activity outcomes following cognitive remediation therapy in schizophrenia: A 1-year follow-up study

Yasuhisa Nakamura et al. PCN Rep. .

Abstract

Aim: Cognitive remediation therapy (CRT) improves cognitive function and enhances vocational outcomes in patients with schizophrenia. However, factors that facilitate employment or vocational activity transition following CRT remain unclear. This study aimed to identify such factors by evaluating the effects of CRT on psychiatric symptoms, cognitive function, divergent thinking, and daily living skills.

Methods: Twenty-one patients with schizophrenia underwent CRT using the Japanese Cognitive Rehabilitation Programme for Schizophrenia. The program included 24 sessions over 3 months, conducted twice weekly in small groups. Each session combined computerized cognitive training and a bridging session to support real-life application. Pre- and post-CRT assessments included the Global Assessment of Functioning (GAF), Positive and Negative Syndrome Scale (PANSS), Brief Assessment of Cognition in Schizophrenia (BACS), modified Tinkertoy Test (m-TTT), Idea Fluency Test (IFT), Design Fluency Test (DFT), and Life Skills Profile (LSP). One year after CRT, participants were classified as engaged in employment or vocational activity or not, and group comparisons identified factors linked to vocational transition.

Results: Pre- and postintervention comparisons showed significant improvements in GAF, PANSS, BACS, m-TTT, IFT, DFT, and LSP scores. In a between-group comparison, those who transitioned to employment or vocational activity (n = 9) exhibited significantly greater reductions in PANSS-negative symptoms than those who did not (n = 12, P = 0.03).

Conclusion: This study suggests an association between reduced negative symptoms and vocational engagement after CRT. Further research with larger samples is needed to clarify this relationship and enhance outcomes through targeted interventions.

Keywords: cognitive remediation therapy; employment transition; occupational outcomes; psychiatric daycare; schizophrenia.

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Conflict of interest statement

The last author (Masaru Mimura) is an Editorial Board member of Psychiatry and Clinical Neurosciences Reports and a co‐author of this article. To minimize bias, he was excluded from all editorial decision‐making related to the acceptance of this article for publication. Masaru Mimura declares no conflict of interest directly related to this work. The first author (Yasuhisa Nakamura) declares no conflicts of interest.

Figures

Figure 1
Figure 1
Illustrative overview of the Japanese Cognitive Rehabilitation Program for Schizophrenia (JCORES)‐based cognitive remediation therapy and bridging sessions in practice.
Figure 2
Figure 2
Study flowchart illustrating vocational transition status 1 year after cognitive remediation therapy. JCORES, Japanese Cognitive Rehabilitation Program for Schizophrenia.
See this image and copyright information in PMC

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