精神分裂病者の作業療法における客観的評価—探索眼球運動の解析を用いて

Biological evaluation of occupational therapy in schizophrenic patients: Analysis of exploratory eye movement

要旨：精神分裂病者25名を対象に作業療法の評価尺度として作業療法出席率およびLASMIのWORK項目にて評価を行うとともに，生理学的評価として探索眼球運動の平均停留時間・停留点総数・平均移動距離・総移動距離を解析した．また，対照として健常者25名の探索眼球運動を計測した．精神分裂病者群では健常者群に比較して平均停留時間の有意な延長，停留点総数の有意な減少，平均移動距離と総移動距離の有意な短縮が観察された．そして，作業療法出席率およびWORK評価結果と平均停留時間・平均移動距離・総移動距離に有意な正の相関が観察された．以上より探索眼球運動は作業療法の客観的評価になりうることが示唆された．

　We have very few biological evaluations that are useful to psychiatric occupational therapy (OT). The present study was performed to evaluate an occupational therapy with exploratory eye movement using an eye-mark recorder. The eye movements were analyzed for four parameters: mean gazing time, total number of gazing points, mean and total scanning length of gazing points.

　OT was done in 25 schizophrenic patients with several occupational tasks. The OT was evaluated by the rate of presence per one month at OT and Work (W) scale of LASMI. Informed consent was taken at each recording of each subject.

　There were significant differences, with regard to four-eye measurements, between schizophrenic and healthy subjects. The schizophrenic patients had significantly longer gazing time and more narrow eye movements than those of healthy subjects. The rate of presence at OT was positively correlated with the mean and total scanning length, and negatively correlated with mean gazing time. The W scale was also positively correlated with the mean gazing time, and negatively correlated with the mean scanning length and total scanning length.

　These results indicated that schizophrenic patients have a limited eye-movement range, which makes it difficult for them to maintain gaze in a given direction for a long time ; these findings are considered to be linked to cognitive deficits and also indicate a signifcant improvement in the exploratory eye movements portion of OT research. The evaluation of the exploratory eye movements may be a useful tool as an additional evaluation of OT.