Psychosocial Interventions in the Rehabilitation and the Management of Psychosis and Schizophrenia: A Systematic Review on Digitally-Delivered Interventions.

Abstract

Background: Schizophrenia and psychotic disorders are disabling, complex and severe psychiatric conditions, which may pose a significant therapeutic challenge. Integrating current psychopharmacological treatment with psychosocial interventions demonstrated a higher efficacy in terms of prognosis. However, most schizophrenia or psychotic patients may have restricted or no access to evidence-based psychosocial interventions, mainly due to poor dissemination of specialized interventions or stigma. Therefore, we aim to systematically review all studies about the current evidence on the feasibility, acceptability, efficacy, effectiveness, and benefits of digitally-delivered psychoeducational and psychosocial interventions for individuals suffering from schizophrenia or psychotic disorders.

Methods: A systematic literature review was conducted of the literature from 2000 to 2024 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, by using PubMed-MEDLINE, Scopus and OVID databases and combining the search approach using both free text terms and Medical Subject Headings (MESH) headings for the topics "psychoeducation", "psychosocial intervention" and "psychosis" and "schizophrenia".

Results: Out of a total of 3042 reviewed papers, 69 studies were included here. The interventions included web-based family and individual psychoeducation, integrated web-based therapy, social networking, peer and expert moderation, virtual reality-assisted and mobile-based psychosocial interventions. Results showed that digitally-delivered interventions have a positive effect in ensuring the continuity and maintenance of the effectiveness of psychosocial treatments, by providing personalized, flexible, and evidence-based interventions to patients with psychosis and/or schizophrenia. At the same time, the studies included demonstrated the acceptability and feasibility of this kind of intervention in clinical practice.

Conclusions: Digital interventions have the potential to deliver non-stigmatizing, constantly available psychosocial and psychoeducational interventions in psychosis and schizophrenia by increasing access to mental health care and not costly interventions. However, further randomized controlled trials (RCTs) and observational studies should compare and evaluate the effectiveness and feasibility of web-based vs. face-to-face psychosocial interventions amongst schizophrenia and psychosis individuals.