M35. A Pilot Randomized Controlled Trial of the Occupational Goal Intervention Method for the Improvement of Executive Functioning in Patients With Treatment-Resistant Schizophrenia

Background: 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. Methods: 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: The results showed significant statistical differences, favoring the OGI group in terms of improvement on the BADS, in the subtests Action Program ( d = 0.72, P = .076), Key Search ( d = 0.87, P = .035) and Zoo Map ( d = 0.81, P = .050) and the BADS total score ( d = 0.87, P = .035). Improvements in EFs were observed by families in various dimensions as measured by different subtests of the ILSS-BR inventory: Personal Hygiene ( d = 1.27, P = .004), Household ( d = 1.27, 0.003), Food prepare/storage ( d = 1.76, P = .000), Leisure ( d = 1.07, P = .012) and ILSS-BR total score ( d = 1.82, P = .000). The OGI group showed no significant results in secondary outcomes (DAFS-BR) except in terms of improvement of communication skills ( d = 0.85, P = .040). Conclusion: Although preliminary, the OGI method has been shown to be reliable and effective for patients with TRS, improving social and functional aspects.