Randomized and controlled trial to evaluate efficacy of occupational therapy in the rehabilitation of executive functions in patients with schizophrenia resistant

Abstract

Recent studies estimate that most patients with schizophrenia show significant cognitive impairments compared with healthy people. Cognitive deficits such as attention, memory, and particulary executive functions are the areas heavily damaged in patients with schizophrenia. Such deficits are strong predictors of long-term functional outcomes such as performance in basic activities of daily living, instrumental activities of daily living, social activities and professional than the positive symptoms and negatives symptoms. The psychopharmacological treatment can be effective on positive symptoms and prevent relapse but do not have the same impact on cognitive impairment,negative and functional. Some evidence suggest that the combination of psychopharmacological and psychosocial support can be effective in proving certain specific dimensions of psychopathology of schizophrenia. The objective of this study is to evaluate the effectiveness of occupational therapy program based on structured the Occupational Intervention Goals in improproving executive functions in patients with schizophrenia resistent through a single-center study, randomized single blind, controlled study, lasting one year, including the follow-up.The study will be conducted in two groups:one group will receive based on the program estruturado TO (N=30)and the control group (N=30) is a group a craf activities of their choice without the active intervention of therapists. Aspects will be assessed psychiatric, neuropsychological and functional at the beginning, after 30 sesssions and 6 months after the intervention. The scale used to psychiatric evaluation is in the PANSS (for monitoring of psychopathological symptoms during the study). Scals BADS, DAFS-BR, ILSS-BR respectively assess executive functions, functionality and basic and instrumental activities of daily living. The neuropsychological evaluation will include a battery to measure attention, executive functions, memory and intellectual efficiency estimated. Statistical analysis will be used ANOVA for repeated measures and data are also calculated measures of clinical efficacyand effective size and number needed to treat. (AU)