Does vocational support moderate the association between cognitive decline and employment status in persons with schizophrenia and mood disorders?

BackgroundEmployment enhances quality of life among people with mental disorders; however, obtaining and maintaining employment remain challenging. Previous studies have shown that cognitive impairment negatively affects employment, whereas vocational support positively affects employment. Nevertheless, evidence on how vocational support moderates the relationship between cognitive impairment and employment remains limited.ObjectiveTo examine the moderating role of vocational support in the association between cognitive impairment and employment among people with schizophrenia and mood disorders.MethodsA total of 102 outpatients diagnosed with schizophrenia or mood disorders were assessed for cognitive decline, employment status, and participation in vocational support such as vocational rehabilitation, pre-vocational training, and supported employment. Logistic regression analyses examined the interaction between cognitive decline and vocational support on employment status. When a significant interaction was identified, subgroup analyses were conducted for groups with and without vocational support.ResultsLogistic regression analysis revealed a significant interaction between cognitive decline and vocational support on employment status. In subgroup analyses, intelligence quotient (IQ) discrepancy was significantly associated with employment only in the group without vocational support (OR = 8.3, p < 0.01), whereas this association was not observed in the group with vocational support (OR = 0.79, p = 0.56).ConclusionsThese findings suggest that vocational support moderates the association between cognitive decline and employment status. When vocational support is present, the association between cognitive decline and employment is no longer observed. Individualized vocational support strategies informed by cognitive assessment may help facilitate employment.