Therapeutic occupations for symptoms of adults with Schizophrenia: A scoping review

Introduction:
Schizophrenia is a complex mental illness that significantly impacts individuals, families, and communities. While pharmacological and psychosocial interventions are well-documented, the role of occupation in symptom management remains underexplored. This scoping review aimed to map existing evidence on the effectiveness of occupation-based interventions in reducing symptoms among adults with schizophrenia.

Method:
Guided by Arksey and O’Malley’s scoping review framework and reported using the PRISMA-ScR guidelines, a comprehensive search was conducted across Web of Science, PubMed, CINAHL, and Scopus databases for articles published between August 2013 and 2022. Relevant studies were identified and systematically analyzed.

Results:
Eighty-five studies met the inclusion criteria. Of these, 87% (n=74) reported reduced symptom severity when individuals used occupations. The most utilized occupations were health management (n=40), leisure (n=11), work (n=7), and combined occupations (n=14).

Discussion:
Occupation-based interventions appear to positively influence symptom reduction in individuals with severe mental illness. These findings align with occupational therapy theories emphasizing ‘doing’, ‘being’, and ‘belonging’ as pathways to improved well-being. No studies reported symptom exacerbation, suggesting occupations are generally safe. However, geographic concentration and potential publication bias limit generalizability.

Conclusion:
Engagement in occupations was associated with symptom reduction in adults with schizophrenia. Further rigorous and culturally diverse research is needed to confirm efficacy and identify optimal conditions for implementation.