A systematic review of occupation- and activity-based health management interventions for adult patients with severe mental disorders.

Background: Considering the negative effects of severe mental disorders (SMDs) on the patient's social and occupational functioning and general health, besides accumulating evidence on the effectiveness of occupation- and activity-based health management interventions for these patients and the novelty of research on this topic, it is important to review, evaluate, and categorize relevant studies. The present study aimed to systematically review occupation- and activity-based health management interventions for adult patients with SMDs.

Materials and methods: The present study is a systematic review. We conducted a literature search in Medline, OTseeker, Cochrane Library, Embase, CINAHL, PubMed, PsycINFO, ISI Web of Science, MagIran, ISC, and SID databases from 2000 until October 2021. The study population consisted of patients clinically diagnosed with SMDs (e.g., schizophrenia, bipolar disorder, and major depression). After the literature search, we investigated the screening, quality, and inclusion and exclusion criteria of the articles. In the primary search, we extracted 238 relevant articles, and after appraising their titles and abstracts, we identified 55 relevant articles. After reviewing the full text of the articles and removing duplicates, 17 articles met the inclusion criteria of this study, while we excluded two articles from the quality assessment. Finally, we reviewed 15 studies. The outcomes included all positive and negative treatment effects and outcomes of the interventions.

Results: According to the results, there were multiple occupation- and activity-based interventions for patients with SMDs, which could directly or indirectly improve their general functioning and health management.

Conclusion: The reviewed studies had numerous blind spots and limitations, such as common shortcomings of randomized clinical trials, lack of long follow-ups, and ambiguity or dispersion of intervention protocols. Besides addressing these limitations, we also discussed research proposals in this study.