S39. RANDOMIZED AND CONTROLLED TRIAL TO EVALUATE THE EFFICACY OF OCCUPATIONAL THERAPY IN THE REHABILITATION OF EXECUTIVE FUNCTIONS IN PATIENTS WITH TREATMENT-RESISTANT SCHIZOPHRENIA
| Autor: | Adriana Dias Barbosa Vizzotto, Helio Elkis, Diego Luis Celestino, Isabel Cristina Napolitano, Graca M. R. Oliveira, Alexandra Martini de Oliveira, Elaine Di Sarno, Patricia Cardoso Buchain |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Occupational therapy
medicine.medical_specialty Poster Session III Rehabilitation business.industry medicine.medical_treatment Executive functions law.invention Psychiatry and Mental health Randomized controlled trial law Physical therapy Medicine In patient Treatment resistant schizophrenia business |
| Popis: | BACKGROUND: Schizophrenia is one of the top 25 causes of disability worldwide. Individuals who develop the disease have relevant cognitive impairments over a long period of time. The combination of pharmacological and psychosocial treatments is effective in improving the psychopathological dimensions of schizophrenia, but the majority of patients present significant cognitive deficits, especially in executive functions (EF) with an impact on functionality, making life independent. The Occupational Goal Intervention (OGI) method is effective in improving EF but has not been tested in patients with resistant schizophrenia (RE). We conducted a pilot study whose results were described in the journal Psychiatry Research. The present study includes the complete 6-month follow-up study. This is a clinical trial comparing Occupational Therapy (OT), based on the OGI method for the rehabilitation of EF, with a control group of individuals with RE. METHODS: The study was developed in 3 stages: baseline, post-treatment, and follow-up. Fifty-four patients diagnosed with RE were randomized and divided into two groups: experimental and control (placebo). The experimental group received 30 OT sessions with the OGI method, and the control group received 30 sessions of free-choice craft activities without active therapist intervention (placebo). Primary outcome measures were evaluated by the BADS and secondary endpoints by DAFS-BR and ILSS-BR. The impact on cognition was assessed by a standard neuropsychological battery, which measured the following functions: attention, verbal fluency, EF, memory, and estimated IQ. PANSS scales and CGI were used to monitor the severity of psychopathological symptoms. Efficacy was assessed in the three study times by means of the linear analysis of mixed effects and the effect size obtained by means d of Cohen. RESULTS: A significant improvement was observed with mean to high effect sizes in the total BADS (d = 0.73), with a small reduction in follow-up (d = 0.69). In DAFS-BR total effect sizes were medium (d = 0.58) but did not sustained at the follow-up (d = 0.39). The results of effect sizes in the total ILSS-BR were high (d = 1.09) and with an increase in clinical follow-up at follow-up (d = 1.19). No changes were observed in the cognitive functions evaluated by the neuropsychological battery. DISCUSSION: The OGI method proved to be effective in improving the majority of EF related to inhibitory control capacity, planning, problem-solving, and mental flexibility of RE patients when compared to placebo, which was maintained 6 months after follow-up. |
| Databáze: | OpenAIRE |
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