Morris Karen, Reid Graeme, Spencer Sally
Department of Health, Psychology & Social Studies, University of Cumbria, Fusehill Street, Carlisle, UK, CA1 2HH.
Cochrane Database Syst Rev. 2018 Oct 5;10(10):CD012398. doi: 10.1002/14651858.CD012398.pub2.
Schizophrenia is a severe mental health condition that is characterised by positive symptoms, such as hallucinations and delusions; negative symptoms, such as flattened affect, thought disorder (disrupted speech), and lack of motivation; and cognitive symptoms, such as problems with memory and attention. Schizophrenia can occur as an isolated episode, or as a recurring cycle of remission and relapse, and is associated with impairment in psychosocial and occupational functioning.Although antipsychotic drugs are the main treatment for people with schizophrenia, in most countries mental health services usually provide a range of add-on interventions, including occupational therapy. This is a complex intervention designed to support and enable continued participation in daily life through engagement in activities and occupations meaningful to the individual. Occupational therapists are professionals trained to deliver therapy where the emphasis is on improving occupational function and participation rather than treating symptoms, and uses a wide range of methods based on the needs of individuals. However, similar interventions may also be delivered by staff not trained as occupational therapists.
To examine the effects of occupational therapy delivered by occupational therapists compared to occupational therapy delivered by any other person for people with schizophrenia.
We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (including trial registers) on 4 November 2016 and 26 July 2018.
All randomised controlled trials evaluating the functional or clinical outcomes of occupational therapy, or both, for people with schizophrenia delivered by occupational therapists compared with occupational therapy for people with schizophrenia delivered by anyone other than occupational therapists.
Review authors independently inspected citations, selected studies, extracted data, and appraised study quality.
The search yielded 1633 records. Of these, we retrieved 17 full-text reports (14 studies) for further scrutiny, which we subsequently excluded as they did not meet our inclusion criteria.
AUTHORS' CONCLUSIONS: Currently there are no randomised controlled trials comparing delivery of occupational therapy for people diagnosed with schizophrenia by occupational therapists with delivery of similar interventions by anyone other than occupational therapists. Research studies employing methodologically robust trial designs are needed to establish whether or not there are better outcomes for people with a diagnosis of schizophrenia with occupational therapy that is delivered by trained occupational therapists.
精神分裂症是一种严重的心理健康状况，其特征包括阳性症状，如幻觉和妄想；阴性症状，如情感平淡、思维紊乱（言语混乱）和缺乏动机；以及认知症状，如记忆和注意力问题。精神分裂症可以作为孤立发作出现，也可以是缓解和复发的反复循环，并且与心理社会和职业功能受损有关。虽然抗精神病药物是精神分裂症患者的主要治疗方法，但在大多数国家，心理健康服务通常提供一系列附加干预措施，包括职业治疗。这是一种复杂的干预措施，旨在通过参与对个人有意义的活动和职业来支持并使患者能够继续参与日常生活。职业治疗师是经过培训提供治疗的专业人员，其重点是改善职业功能和参与度而非治疗症状，并根据个人需求使用多种方法。然而，类似的干预措施也可能由未接受职业治疗师培训的工作人员提供。
比较职业治疗师提供的职业治疗与其他任何人提供的职业治疗对精神分裂症患者的效果。
我们于2016年11月4日和2018年7月26日检索了Cochrane精神分裂症研究组基于研究的试验注册库（包括试验登记册）。
所有随机对照试验，评估职业治疗师为精神分裂症患者提供的职业治疗的功能或临床结局，或两者皆有，并与非职业治疗师为精神分裂症患者提供的职业治疗进行比较。
综述作者独立检查文献、选择研究、提取数据并评估研究质量。
检索得到1633条记录。其中，我们检索到17篇全文报告（14项研究）以供进一步审查，随后由于它们不符合我们的纳入标准而将其排除。
目前尚无随机对照试验比较职业治疗师为被诊断患有精神分裂症的患者提供职业治疗与非职业治疗师提供类似干预措施的情况。需要采用方法学上稳健的试验设计进行研究，以确定由训练有素的职业治疗师提供职业治疗对精神分裂症患者是否会产生更好的结局。
