Article

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.

Langue : ANGLAIS