Effects of Home-visit Occupational Therapy Using a Management Tool for Daily Life Performance on Severe Mental Illness: A Multicenter Randomized Controlled Trial.

AIM

Effective intervention is necessary for improving the social functioning of patients with severe mental illness (SMI). We examined the effects of home-visit occupational therapy (OT) using a Management Tool for Daily Life Performance (MTDLP) that was designed to support patients in completing their desired daily life activities. The control group were treated by home-visit OT without using MTDLP.

METHOD

In this multicenter randomized controlled trial, 60 participants included adults aged 18-65 with an ICD-10 diagnosis of F2 (i.e., schizophrenia, schizotypal and delusional disorders) or F3 (i.e., mood [affective] disorders) and who utilized one of the 20 psychiatric outreach teams in Japan. Participants were randomly assigned into two groups: MTDLP (n = 29), control (n = 31). Home-visit OT was provided to both groups, once a week, for four months. A repeated-measures analysis of variance was conducted to compare changes in participants' social functioning using the Global Assessment of Functioning (GAF) and the Social Functioning Scale (SFS).

RESULTS

The GAF scores of the MTDLP group improved significantly greater than those of the control group. No significant change in SFS total scores was found between the groups; however, the Employment/Occupation scores (an SFS subscale) of the MTDLP group significantly improved compared to the controls.

CONCLUSION

These findings suggest that MTDLP can increase the social functioning of people with SMI more so than controls. Thus, home-visit OT using MTDLP that is intensively focused on the patient's desires and implemented in the real-world environment appears to contribute to improvements in social functioning.