Schizophrenia is a progressive psychotic disorder characterized by the presence of hallucinations and delusions. Individuals with Schizophrenia are unaware of their psychotic symptoms.
Symptoms
Physical
- Disorganized behaviour
- Catatonic behaviour
- Change in social skills
- Decrease in motor function
- Decrease in visual processing ability
Cognitive
- Delusions
- Hallucinations
- Disorganized thinking
- Decreased judgement and insight
- Impulsivity
- Decreased executive function, memory, and attention
- Decreased communication ability
Affective
- Anhedonia
- Avolition
- Apathy
- Anxiety
- Dysphoria / Depression
Assessments
Physical
Cognitive
- Montreal Cognitive Assessment (MoCA)
Affective
- Beck’s Depression Scale
- Patient Health Questionnaire 9 (PHQ-9)
- Hospital Anxiety and Depression Scale (HADS)
Function
- Canadian Occupational Performance Measure (COPM)
- Bay Area Functional Performance Evaluation (BaFPE)
- Activity Card Sort
- Assessment of Motor and Process Skills (AMPS)
Common Occupational Performance Issues (OPIs)
Self-Care
- Decreased interest, motivation, and energy to perform grooming, bathing, and dressing activities
- Difficulty with grooming activities due to decreased visual processing ability
- Impact of condition on employment may lead to unstable finances and housing
- Poor attention to nutrition
- Difficulty with medication compliance
- Social isolation
Productivity
- Stigma may lead to social isolation or dropout at school or work
- Difficulty coping in fast, unpredictable environments
- Cognitive changes may negatively impact focus and performance at school / work
- Difficulty managing household and finances
Leisure
- Social isolation
- Decreased occupational engagement
Frames of Reference
- Environmental
- Compensatory
- Strength-based
Interventions
Self-Care
ADLs: task simplification, establish routines, assistive devices as required with education regarding safe and proper use, ADL training and practice
Condition Management: psychoeducation regarding illness, medication compliance and management, relapse prevention
Productivity
Work / School: job demands analysis (JDA), functional abilities evaluation (FAE), advocate for client’s needs to employer / school (e.g. flexible schedule, task modifications, structured job / class demands)
Home: establish routines, task modification and simplification, group therapy for management of IADLs (e.g. food preparation, financial management), referral for community services (e.g. home management, laundry, meal service, shopping)
Leisure
Leisure Exploration: explore meaningful occupations, introduce group programs, develop safe and supportive social networks
Leisure Participation: develop routines and coping plans to help client feel safe when participating in leisure activities