Occupational Goal Intervention Method for the Management of Executive Dysfunction in People With Treatment-Resistant Schizophrenia: A Randomized Controlled Trial

Abstract

Abstract Importance: The occupational goal intervention (OGI) method has been proven effective in improving executive function (EF) in people with schizophrenia, but it has not yet been tested with those with treatment-resistant schizophrenia (TRS). Objective: To test the efficacy of the OGI in people with TRS. Design: Single-blind randomized controlled trial. Setting: The Schizophrenia Program, Institute of Psychiatry, University of São Paulo General Hospital, Brazil. Participants: People with TRS according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria, ages 18 to 55. Outcomes and Measures: Primary outcome: improvement in EF as measured by the Behavioural Assessment of the Dysexecutive Syndrome (BADS). Secondary outcomes: improvement of functionality, as measured by the Direct Assessment of Functional Status–Revised (DAFS–BR), and improvement in autonomy in activities of daily living (ADLs), as measured by the Independent Living Skills Survey (ILSS–BR), administered to caregivers. The outcomes were measured at baseline, posttreatment, and follow-up. Intervention: Participants were divided into two groups: OGI and craft activities (control). Each group participated in 30 sessions during 15 wk, with follow-up at 6 mo postintervention. Results: The OGI group improved significantly compared with the control group, with medium to large effect sizes in posttreatment scores on the BADS and DAFS–BR. The ILSS–BR showed the highest effect sizes at posttreatment and follow-up. Conclusions and Relevance: The OGI method is effective for improving EF, occupational performance and ADLs in people with TRS. What This Article Adds: The OGI method is an important therapeutic tool for use in the occupational therapy clinic.