Effect of occupational therapy on cognitive functions and occupational performances in hospitalized patients with mental-health disorder: A single-arm interventional study

Abstract

Background: Cognitive dysfunction, a distressing outcome of mental-health disorders (MHDs), hinders an individual's occupational performance (OP). OP is the outcome of dynamic interaction between a person, their unique environment and occupation. With only pharmacological treatment, symptom reduction was not in pace with the recovery rate of cognitive and OP dysfunction resulting persistence of these dysfunctions even post-hospital discharge. Hence, occupational therapy (OT) intervention before discharge would be required, for patient's functioning at premorbid level postdischarge. However, till date, very few Indian studies on the effect of OT on cognition and OP in individuals with MHDs are done with under-representation of the client population. Objectives: To study the effect of OT on cognitive functions and OP in hospitalized patients with MHDs. Study Design: A single-arm interventional study was conducted. Methods: Based on the selection criteria, 88 patients who were (aged 18–55 years) diagnosed with MHDs and were admitted in the hospital were enrolled after screening during their first visit to OT department using the purposive sampling method. Participants recruited were categorized into diagnostic groups: schizophrenia, neurotic disorders, mood disorders, and alcohol-substance use disorders for data analysis. Patients were assessed on Mini-Mental State Examination (MMSE) and comprehensive OT evaluation (COTE) scale pre- and post-therapy after 3 weeks, i.e. after 6 sessions. Cognitive-OP focused-OT intervention was given twice a week. Results: The descriptive data analysis showed an increase in performance posttherapy for all subtests (except Language-praxis subtest in Group-Neurotic Disorders) and overall scores of both assessments in all the groups. Total MMSE performance both pre- and post-therapy was better than total COTE performance in all the groups. Posttherapy, maximum improvement was observed in Recall among MMSE subtests and in Task-behavior among COTE subtests across all groups. Inferential data analysis showed highly significant improvement posttherapy for total MMSE and total COTE scores (P < 0.01, 95% confidence interval: Groups: schizophrenia [(−3.218, −2.302) and (15.991, 18.329)], neurotic disorders [(−3.169, −1.631) and (13.230, 18.970)], mood disorders [(−3.100, −1.650) and (15.095, 19.155)] and Group: alcohol and substance-use disorders [(−4.210, −1.456) and (17.855, 22.47)] respectively). Conclusion: OT intervention is effective in improving cognitive and OP in hospitalized patients with MHDs.