統合失調症の認知機能障害に対する個別作業療法の効果

Effects of individual occupational therapy on cognitive impairment in schizophrenia

要旨：統合失調症の認知機能障害に対する個別作業療法の効果を検討した．新規入院患者を対象に，目標指向的な個別作業療法群（介入群）または課題指向的な作業療法群（対照群）に任意に割り付け，3ヵ月後の効果をBACS-J，PANSS，GAFで評価した．41名が対象となり介入群は25名，対照群は16名であった．介入前の評価には両群間で有意差はなかった．3ヵ月後，介入群ではBACS-Jの言語性学習記憶，ワーキングメモリ，言語流暢性，注意と処理速度，遂行機能，総合得点，PANSSの陽性症状が有意に改善した．本研究は目標指向的な個別作業療法が回復早期の統合失調症の認知機能障害と精神症状を改善させることを示している．

　The objective of this study was to investigate the effects of individual occupational therapy on cognitive impairment in schizophrenia. Participants of this study were recruited from inpatients with schizophrenia at a psychiatric hospital. They were assigned to the individually structured goal-oriented individual occupational therapy group (intervention group) or the voluntarily structured task-oriented occupational therapy group (control group) by voluntary selection. The effects were assessed by the Brief Assessment of Cognition in Schizophrenia-Japanese version (BACS-J), the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale (GAF) before and after 3 months of occupational therapy intervention. Forty-one participants were divided into the intervention group (n=25) and the control group (n=16). Before the occupational therapy intervention, there were no significant group differences in the assessment results. Three months after the occupational therapy intervention, participants in the intervention group demonstrated significant improvements in verbal memory, working memory, verbal fluency, attention, executive function, and composite score of BACS-J and in positive scale of PANSS. This study suggests that the goal-oriented individual occupational therapy improves cognitive impairment and decreases psychiatric symptoms of people with schizophrenia in the early recovery stage.