T Shimada, M Ohori, Y Inagaki, Y Shimooka, I Ishihara, N Sugimura, S Tanaka and M Kobayashi,
Psychiatry and clinical neurosciences, May 2019 11
We examined the effect of individualized occupational therapy (IOT) compared to the usual group occupational therapy (GOT) on the rehospitalization of patients with schizophrenia.A prospective cohort study included patients with schizophrenia who were discharged within one year from a psychiatric hospital. Time to rehospitalization by treatment group (GOT + IOT; GOT alone) was evaluated with Kaplan-Meier survival analysis. The impact of demographics and clinical factors associated with rehospitalization were investigated using Cox proportional hazards models.Of the 111 patients who met the criteria, 54 were in GOT + IOT and 57 in GOT alone groups. Over the two years from discharge, the overall rehospitalization rate was 51.376% (56 patients), 16 of whom received GOT + IOT demonstrated a significantly lower rehospitalization rate compared to 40 of whom received GOT alone. Time to rehospitalization was significantly longer for GOT + IOT group compared to those in GOT alone (p < 0.001). The multivariate Cox proportional hazards models showed that type of OT (HR = 0.543), medication adherence (HR = 0.343), access to resident support persons (HR = 0.450), and executive function at discharge (HR = 0.740) were all significantly associated with rehospitalization.Our results provide support for the prolonging effects of IOT in relation to rehospitalization and the reduction of rehospitalization risk compared to patients with schizophrenia who receive GOT alone, in addition to supporting good cognition at discharge and favorable medication adherence. This article is protected by copyright. All rights reserved.