title: A pilot randomized controlled trial of the Occupational Goal Intervention method for the improvement of executive functioning in patients with treatment-resistant schizophrenia.
abstract: Schizophrenia is a chronic disabling mental disorder that involves impairments in several cognitive domains, especially in executive functions (EF), as well as impairments in functional performance. This is particularly true in patients with Treatment-Resistant Schizophrenia (TRS). The aim of this study was to test the efficacy of the Occupational Goal Intervention (OGI) method for the improvement of EF in patients with TRS. In this randomized, controlled, single-blind pilot study, 25 TRS patients were randomly assigned to attend 30 sessions of either OGI or craft activities (control) over a 15-week period and evaluated by the Behavioural Assessment of the Dysexecutive Syndrome (BADS) as the primary outcome and the Direct Assessment of Functional Status (DAFS-BR) as well as the Independent Living Skills Survey (ILSS-BR) as secondary outcomes, all adapted for the Brazilian population. The Positive and Negative Syndrome Scale (PANSS) was used for monitoring symptom severity. Results showed significant statistical differences, favoring the OGI group in terms of improvement on the BADS, both in subtests (Action Program and Key Search) and the total score. Improvements in EFs were observed by families in various dimensions as measured by different subtests of the ILSS-BR inventory. The OGI group showed no significant results in secondary outcomes (DAFS-BR) except in terms of improvement of communication skills. Although preliminary, our results indicate that the OGI method is efficacious and effective for patients with TRS.
authors.affiliation: Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil. Electronic address: adrivizzotto@gmail.com.
authors.forename: Adriana D B
authors.initials: AD
authors.lastname: Vizzotto
authors.affiliation: Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Diego L
authors.initials: DL
authors.lastname: Celestino
authors.affiliation: Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Buchain
authors.affiliation: Service of Occupational Therapy, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Oliveira
authors.affiliation: Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Service of Psychology and Neuropsychology, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Graça M R
authors.initials: GM
authors.lastname: Oliveira
authors.affiliation: Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Elaine S
authors.initials: ES
authors.lastname: Di Sarno
authors.affiliation: Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Isabel C
authors.initials: IC
authors.lastname: Napolitano
authors.affiliation: Schizophrenia Research Program, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: Helio
authors.initials: H
authors.lastname: Elkis
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000328:Adult; D001938:Brazil; D003072:Cognition Disorders / Q000534:rehabilitation*; D000072466:Cognitive Remediation / Q000379:methods*; D003131:Combined Modality Therapy; D056344:Executive Function; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012050:Rehabilitation, Vocational / Q000379:methods*; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: Executive function; Occupational therapy; Rehabilitation