Effectiveness of augmented Individual Placement and Support interventions for competitive employment in people with schizophrenia: Systematic review and meta-analysis.

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...

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Publicado en:Salud Mental Vol. 41; no. 4; pp. 187 - 198
Autores principales: Vázquez-Estupiñán, Martin Felipe, Durand-Arias, Sol, Astudillo-García, Claudia Iveth, de León, Eduardo Ángel Madrigal
Formato: Artículo
Publicado: Instituto Nacional de Psiquiatria Ramon de la Fuente jul/ago2018
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Effectiveness of augmented Individual Placement and Support interventions for competitive employment in people with schizophrenia: Systematic review and meta-analysis.
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        au:
          Vázquez-Estupiñán, Martin Felipe
          Durand-Arias, Sol
          Astudillo-García, Claudia Iveth
          de León, Eduardo Ángel Madrigal
        affil: Servicios de Atención Psiquiátrica, Secretaría de Salud, Ciudad de México, México
      su:
        Employment of people with disabilities
        Schizophrenia
        Supported employment
        People with schizophrenia
        Employment agencies
        Psychosocial factors
        Intervention (Social services)
      sug:
        subj:
          Employment of people with disabilities
          Schizophrenia
          Supported employment
          People with schizophrenia
          Employment agencies
          Psychosocial factors
          Intervention (Social services)
      keyword:
        literature review
        meta-analysis
        schizophrenia
        Empleos subvencionados
        esquizofrenia
        literatura de revisión
        metaanálisis
      ab:
        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], I² = 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.
        Antecedentes. Se ha estimado que más del 70% de las personas que viven con diagnóstico de esquizofrenia desean trabajar. El modelo Individual Placement and Support (IPS) ha mostrado efectividad para que las personas con esquizofrenia consigan un empleo competitivo. Sin embargo, en esta población no se ha evaluado la eficacia de las intervenciones aumentadas de IPS -es decir, aquellas que añaden al modelo una intervención psicosocial-. Objetivo. Evaluar la eficacia de las intervenciones aumentadas de IPS dirigidas a la obtención de empleo competitivo en personas con esquizofrenia. Método. Se realizó una revisión sistemática de la literatura de ensayos clínicos aleatorizados sobre intervenciones aumentadas de IPS publicados en inglés entre 2007 y 2017, en las bases de datos electrónicas de PubMed, Science Direct y EBSCO. Se calcularon el riesgo de sesgo y las tasas de empleo competitivo. Se realizó un metaanálisis mediante el método de efectos aleatorios para estimar el efecto de las intervenciones aumentadas de IPS. Resultados. Se identificaron 12 artículos en los que se comparaban 10 intervenciones aumentadas de IPS con alguna otra intervención. En ocho estudios realizados en personas con esquizofrenia, la intervención se basó en IPS + habilidades sociales/habilidades laborales/remediación cognitiva vs. IPS o IPS modificadas, sin que se encontrara un efecto general en favor de las intervenciones aumentadas (RR = 1.37, 95% IC [.97, 1.95], I² = 52%). Las intervenciones aumentadas de IPS tienden a ser más efectivas cuando se llevan a cabo en el primer episodio psicótico. Discusión y conclusión. No se puede concluir que las intervenciones aumentadas de IPS tengan un mayor efecto sobre las intervenciones estándar de IPS para la obtención de empleo competitivo en personas con esquizofrenia.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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