Cet article dresse un état des lieux de l’implication du fonctionnement cognitif
dans le champ de l’insertion professionnelle et du maintien en emploi des personnes qui
souffrent de troubles du spectre schizophrénique (TSS). L’objectif est de visualiser comment
les déficits cognitifs s’articulent avec les autres dimensions du handicap rapportées dans
la Classification internationale du fonctionnement, du handicap et de la santé (CIF), dans
le domaine du travail. Les données de la littérature vont dans le sens du modèle de la CIF,
à savoir un plus fort impact du fonctionnement cognitif sur les limitations d’activités (LA)
plutôt que sur les restrictions de participation (RP). Ce sont en effet davantage les
facteurs environnementaux et personnels qui prédisent la participation au travail. En
conclusion, ce cadre théorique offre de nouvelles perspectives, notamment que la prise en
compte de l’interaction entre les déficits cognitifs et les limitations d’activités peut
venir étayer l’accompagnement vers et dans l’emploi des personnes souffrant de
TSS.Objectives Cognitive impairment can be a barrier to employment of
people with a schizophrenia spectrum disorder (SSD). However, other factors have also been
identified as potentially hindering work integration and job tenure. But the links between
all these factors remain unknown. The objective of this article is to propound an
integrative model, using the International Classification of Functioning (ICF), of how
cognitive impairment associated with SSD is related to other factors involved in
difficulties in work integration and job tenure.Methods The description of the theoretical framework of the ICF
enables to organize these factors in a comprehensive model. Then, a review of recent
literature allows us to identify factors associated with employment of people with SSD, and
to see the link between cognitive functioning and other factors.Results Most of reviewed studies find moderate correlations or no
correlation between cognitive impairments and work integration or job tenure. Stronger
correlations were nevertheless found between cognitive factors and work behavior or
performance. Considering other factors, like personal or environmental factors, and the
framework of the ICF, a comprehensive view of the vocational rehabilitation for people with
SSD is developed. Interactions between some personal (e.g. self-efficacy or self
esteem) and environmental (e.g. job coach or layout of workstation) factors may
influence the translation of cognitive difficulties into work participation
restrictions.Conclusion Vocational rehabilitation programs should further
consider the complexity of interactions between cognitive, personal and environmental
factors, and how they impact work functioning. As defined in ICF, activity limitations may
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