Insight and negative symptoms as predictors of functioning in a work setting in patients with schizophrenia

The present study was conducted to explore correlates of vocational outcome for individuals with schizophrenia. Seventy-eight individuals with schizophrenia were recruited to take part in a supported employment program in which they were provided with approximately 6 months of part-time work through a VA hospital. Positive symptoms, negative symptoms, and level of insight into mental illness were assessed once every 4 weeks, in addition to a work performance evaluation with participants' supervisors. Hierarchical longitudinal regression analysis revealed that negative symptom severity and impaired insight were significantly associated with poor work performance, and this relationship persisted over time. By contrast, positive symptom severity was not significantly associated with work performance. These results indicate that insight and negative symptoms, which can fluctuate over time, may be driving fluctuations in work performance and may therefore be a valuable target for future interventions.