2017 Volume 63 Issue 1 Pages 22-29
Recently, the use of community transition for psychiatric inpatients with schizophrenia has been accelerated. However, achieving successful transition support for refractory patients is sometimes difficult due to the absence of a trusting relationship which is caused by the patients' psychiatric symptoms. We herein report a case of treatment-resistant schizophrenia, for whom we successfully introduced community transition support by a multidisciplinary team through individual occupational therapy. The patient was a woman with catatonic schizophrenia, who presented with severe negativism when symptoms were in the acute phase. In the chronic phase, her symptoms prominently decreased, yet she kept rejecting help and intervention for her daily life. By utilizing individual occupational therapy, which has no direct relation with regular transition support, this patient was able to establish a trusting relationship with the occupational therapist, and other members of the multidisciplinary team were thus able to subsequently join the sessions. Training to carry out the activities of daily life was gradually added to this patient's therapeutic regimen, and finally she was successfully discharged from the hospital and thus was able to return home. The role of the occupational therapist successfully carrying out community transition support is discussed through a review of this case.
