Improvement of functional independence of patients with acute schizophrenia through early occupational therapy: a pilot quasi-experimental controlled study

To clarify whether early occupational therapy for patients with acute schizophrenia improves their functional independence.

Quasi-experimental controlled study.

A university hospital in Japan.

Forty-six out of 85 eligible patients with schizophrenia.

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.

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.

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.

The results suggest that early occupational therapy may improve functional independence in patients with acute schizophrenia.