2018, Number 4
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Salud Mental 2018; 41 (4)
Effectiveness of augmented Individual Placement and Support interventions for competitive employment in people with schizophrenia: Systematic review and meta-analysis
Vázquez-Estupiñán MF, Durand-Arias S, Astudillo-García CI, Madrigal de LEÁ
Language: English
References: 41
Page: 187-197
PDF size: 449.64 Kb.
ABSTRACT
Background. It has been estimated that over 70% of people living with a diagnosis of schizophrenia wish
to work. The Individual Placement and Support (IPS) model has proven to be highly effective in enhancing
competitive employment in people with schizophrenia. However, the efficacy of augmented IPS interventions,
in other words, those that incorporate a psychosocial intervention into the model, has not been evaluated in
this population.
Objective. To assess the efficacy of augmented IPS interventions designed to obtain competitive
employment in people with schizophrenia.
Method. A systematic review of the literature on randomized
clinical trials of augmented IPS interventions, published in English between 2007 and 2017, was conducted in
the electronic databases of PubMed, Science Direct, and EBSCO. Risk of bias and competitive employment
rates were calculated. A meta-analysis was performed using the random effects method to estimate the effect
of augmented IPS interventions.
Results. Twelve articles were identified in which 10 augmented IPS interventions
were compared with other interventions. In eight studies conducted on people with schizophrenia, the
intervention was based on IPS + social skills/work skills/cognitive remediation vs. IPS or modified IPS. No general
effect favoring augmented interventions (
RR = 1.37, 95% CI [.97, 1.95], I
2 = 52%) was found. Augmented
IPS interventions tend to be more effective when they are implemented during the first psychotic episode.
Discussion and conclusion. It is not possible to conclude that augmented IPS interventions have a significant
effect over standard IPS interventions in obtaining competitive employment in people with schizophrenia.
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