A Systematic Review of Intervention to Enhance Mental Health Outcomes of Persons with Schizophrenia during the COVID-19 Pandemic

Abstract

Background and Aim: Schizophrenia is a chronic mental disorder requiring continuous care. During the COVID-19 pandemic, people with schizophrenia (PLWS) faced disproportionate challenges due to healthcare disruptions. Ensuring continuity of care is essential to mitigating the burden of the disorder, and evaluating mental health outcomes helps assess the effectiveness of interventions. This systematic review examines the impact of various interventions on the mental health outcomes of PLWS during the pandemic.
Method and Materials: The protocol was registered on PROSPERO. A comprehensive search was conducted in MEDLINE, Embase, CINAHL, and ScienceDirect for studies published between 2019 and 2023. Eligible studies included experimental (randomized controlled trials and quasi-experimental studies) and non-experimental (observational) designs investigating the effects of interventions on mental health outcomes in PLWS aged 18 years and older. A narrative synthesis was used to report findings, and the quality of included studies was assessed.
Results: Of the 1,236 records screened, nine studies met the inclusion criteria, comprising five experimental and four non-experimental studies. Experimental interventions included virtual and in-person guided walking, animated audio-visual videos, animal-assisted therapy, and nutritional programs. Non-experimental interventions encompassed Metacognitive Reflection and Insight Therapy, Cognitive Behavioral Social Skills Training, vitamin D supplementation, and dietary interventions. These interventions contributed to improvements in physical activity, executive and social function, healthy behaviors, and quality of life. Additionally, positive effects were observed on anthropometric profiles, cardiovascular health, and metabolic syndrome.
Conclusion: This review highlights effective interventions that support mental health outcomes in PLWS during the COVID-19 pandemic. Integrating these approaches into routine schizophrenia care could help mitigate the pandemic’s impact and enhance long-term well-being in this vulnerable population. Further research is needed to evaluate their long-term sustainability and effectiveness.