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Effects of occupational therapy on psychiatric symptoms and social functioning in patients with schizophrenia: a systematic review and meta-analysis
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DOI：10.3389/fpsyt.2026.1862106.png)
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Abstract
En 中文
ObjectiveThe present study aimed to systematically evaluate the impact of occupational therapy on the psychiatric symptoms and social functions of patients with schizophrenia.MethodsA comprehensive literature search was conducted in CNKI; Wanfang Data; VIP Database; PubMed; Web of Science; the Cochrane Library; and Embase from 2015 to February 2026. Randomized controlled trials (RCTs) of occupational therapy assessing its impact on mental symptoms and social functioning in patients with schizophrenia were included. The following data were extracted: author; year; age; country; measures for the control group and the intervention group; diagnostic criteria; sample size; and outcomes. Meta-analysis was performed using RevMan 5.4 and R 4.4.3 software. The primary outcome was psychiatric symptom severity assessed by the total score of the Positive and Negative Syndrome Scale (PANSS); whereas secondary outcomes included social functioning measured by the Social Disability Screening Schedule (SDSS); behavioral and psychiatric symptoms evaluated by the Nurses’ Observation Scale for Inpatient Evaluation (NOSIE); and activities of daily living assessed using the Activities of Daily Living (ADL) scale. Fixed or random-effects models were applied according to heterogeneity; and subgroup analyses were conducted.ResultA total of 10 studies; conducted in China and Japan; were eventually included in this meta-analysis; involving 958 participants (476 in the intervention group and 482 in the control group). The meta-analysis revealed that the occupational therapy group had a significantly lower total PANSS score than the conventional treatment group; suggesting that occupational therapy may contribute to the alleviation of psychiatric symptoms (MD: − 5.76; 95% CI; − 7.72 to − 3.79; p < 0.00001). In terms of social functioning; occupational therapy also demonstrated positive effects; with significantly lower SDSS scores (MD: − 1.06; 95% CI; − 1.94 to − 0.18; p = 0.02) and ADL scores (MD: − 3.50; 95% CI; − 5.20 to − 1.79; p = 0.0001) in the intervention group compared with the control group; as well as a significantly higher NOSIE score (MD: 32.33; 95% CI; 16.37 to 48.30; p < 0.0001); indicating that occupational therapy may improve patients’ daily living abilities.ConclusionOccupational therapy-based interventions may contribute to improvements in psychiatric symptoms and appear to exert positive effects on social functioning and activities of daily living in patients with schizophrenia.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/; CRD420261341828.
Keywords:
systematic review
meta-analysis
schizophrenia
occupational therapy
psychiatric symptoms
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