急性期統合失調症患者一例に対する1対1の個人作業療法でのピアノ演奏の意味について

Significance of individual occupational therapy using piano playing activities for a patient with acute schizophrenia

要旨：本報告の目的は，ある一人の急性期統合失調症患者がピアノ演奏をした経過について述べ，この患者に対する1対1の個人作業療法でのピアノ演奏の意味について報告することである．症例は33歳，男性である．患者は精神症状と疲労のため入院した．入院後15日目に，作業療法が処方された．患者はピアノを弾き，作業療法士は彼の傍で演奏される曲を繰り返し聞いた．患者はピアノ演奏だけを継続し，53日目に退院した．ピアノ演奏には患者にとっての個人的な意味があり，作業療法士はその意味を考慮しながら「添う」ことにより，病気からの回復を支えた可能性があると示唆された．

　The purpose of this study is to discuss individual occupational therapy interventions of piano playing activities as a self-controlled space for a patient with acute schizophrenia. The case was a 33-year-old male who was hospitalized voluntarily due to mental and physical fatigue with auditory hallucinations and persecutory delusions. In addition, prior to admission, he withdrew from the outer world and human relations because of his lack of a sense of security and subsequent anxiety. After admission, he complained of stress. 15 days after admission, individual occupational therapy commenced, focusing on his fatigue and anxiety. The patient played the piano while the occupational therapist listened to his music by his side and refrained from interacting on the stage in the hospital gym. After several sessions, the patient recovered. Occupational activities continued in various forms according to his condition, but he continued to play the piano. The recovery process of this patient suggests that listening to a patient playing piano by his side in the occupational therapy setting may be important for the recovery of patients with acute schizophrenia.