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

摘要

Aim: Effective intervention is necessary for improving the social functioning of patients with severemental illness (SMI). We examined the effects of home-visit occupational therapy (OT) using aManagement Tool for Daily Life Performance (MTDLP) that was designed to support patients incompleting their desired daily life activities. The control group were treated by home-visit OT withoutusing MTDLP. Method: In this multicenter randomized controlled trial, 60 participants included adultsaged 18–65 with an ICD-10 diagnosis of F2 (i.e., schizophrenia, schizotypal and delusional disorders) orF3 (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 OTwas provided to both groups, once a week, for four months. A repeated-measures analysis of variance wasconducted to compare changes in participants’ social functioning using the Global Assessment ofFunctioning (GAF) and the Social Functioning Scale (SFS). Results: The GAF scores of the MTDLPgroup improved significantly greater than those of the control group. No significant change in SFS totalscores was found between the groups; however, the Employment/Occupation scores (an SFS subscale) ofthe MTDLP group significantly improved compared to the controls. Conclusion: These findings suggestthat 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 thereal-world environment appears to contribute to improvements in social functioning.