Gamified interventions for schizophrenia rehabilitation: A systematic scoping review

Abstract

Schizophrenia affects 24 million people worldwide, yet standard rehabilitation remains resource-intensive and its effectiveness inconsistent. To clarify whether game-based approaches can close these gaps, we reviewed studies published between January 2014–June 2025 in PubMed, Web of Science, PsycINFO and the ACM Digital Library. Eighty-two studies comprising about 5800 unique participants met the predefined eligibility criteria and were qualitatively synthesized. Interventions fell into three partially overlapping groups: serious games (n = 38), gamified applications (n = 20), and commercial games (n = 29). Outcomes were clustered into six domains—cognitive function, social function, symptom management, motor function, lifestyle management, and self-efficacy—and benefits proved to be domain- and modality-specific. Virtual reality-based serious games yielded the largest gains in social cognition (Cohen's d = 0.26–1.66). Gamified applications produced moderate-to-large improvements in negative symptoms (d ≈ 0.75–0.90) and achieved the highest engagement indices. Commercial games delivered small-to-moderate enhancements in motor fitness and social functioning (d ≈ 0.22–0.80). Evidence quality remains limited, as only 45 controlled trials were randomized; 12 enrolled at least 100 participants; 10 tracked outcomes beyond three months; only one achieved a low risk-of-bias rating, more than 90 % originated in high-income countries, and fewer than one-third articulated a theoretical framework. The data generally support gamified interventions as promising adjunctive tools rather than standalone replacements for conventional care. Multi-site randomized trials with ≥12-month follow-ups and harmonized core outcome sets, mechanism-driven optimizations that isolate active game mechanics, and cost-effectiveness plus equity analyses are necessary.