RESUMO
OBJECTIVE: To clarify whether early occupational therapy for patients with acute schizophrenia improves their functional independence. DESIGN: Quasi-experimental controlled study. SETTING: A university hospital in Japan. SUBJECTS: Forty-six out of 85 eligible patients with schizophrenia. INTERVENTION: Participants were allocated into an intervention group or a control group according to the month of admission. Activities in one-on-one and mainly non-verbal occupational therapy were provided for the intervention group immediately after admission, and not for the control group. MAIN MEASURES: Functional independence was measured using the Functional Independence Measure (FIM), at admission, at one month and at three months after admission. Psychiatric symptoms were also measured by the Brief Psychiatric Rating Scale. RESULTS: Patients in both groups showed improved FIM total scores at one month and three months after admission. In the intervention group, the medians (interquartile ranges) were 89.0 (44.5) at admission, 113.0 (18.5) at one month, and 121.0 (6.5) at three months. In the control group, they were 88.0 (32.0), 107.0 (39.5), and 111.0 (17.0). At three months, the total FIM scores were significantly higher in the intervention group than in the control group (p = 0.016). In the FIM cognitive domain, the scores were significantly higher in the intervention group than in the control group at one month (p = 0.038) and, three months (p = 0.012). Both groups showed improvement in Brief Psychiatric Rating Scale total scores, while no significant differences were observed between the groups at any points. CONCLUSION: The results suggest that early occupational therapy may improve functional independence in patients with acute schizophrenia.
RESUMO
OBJECTIVE: To compare the therapeutic effects of subject-chosen and therapist-chosen activities in occupational therapy for inpatients with chronic schizophrenia. DESIGN: Prospective comparative study. SETTING: A psychiatric hospital in Japan. SUBJECTS: Fifty-nine patients with chronic schizophrenia who had been hospitalized for many years. INTERVENTIONS: The subjects received six-months occupational therapy, participating in either activities of their choice (subject-chosen activity group, n = 30) or activities chosen by occupational therapists based on treatment recommendations and patient consent (therapist-chosen activity group, n = 29). MAIN MEASURES: The Positive and Negative Syndrome Scale and the Global Assessment of Functioning (GAF) Scale were used to evaluate psychiatric symptoms and psychosocial function, respectively. RESULTS: After six-months occupational therapy, suspiciousness and hostility scores of the positive scale and preoccupation scores of the general psychopathology scale significantly improved in the subject-chosen activity group compared with the therapist-chosen activity group, with 2(2) (median (interquartile range)) and 3(1.25), 2(1) and 2.5(1), and 2(1) and 3(1), respectively. There were no significant differences in psychosocial functions between the two groups. In within-group comparisons before and after occupational therapy, suspiciousness scores of the positive scale, preoccupation scores of the general psychopathology scale, and psychosocial function significantly improved only in the subject-chosen activity group, with 3(1) to 2(2), 3(1) to 2(1), and 40(9) to 40(16) respectively, but not in the therapist-chosen activity group. CONCLUSIONS: The results suggested that the subject-chosen activities in occupational therapy could improve the psychiatric symptoms, suspiciousness, and preoccupation of the inpatients with chronic schizophrenia.
