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Systematic Review
Six primary studies on the clinical effectiveness of various types of OT programs met the selection criteria to be included in this report,20-25 consisting of 1 study on adults with depression and/or anxiety disorders25 and 5 studies on patients diagnosed with SZ. 20-24 In an RCT by Gunnarsson and colleagues (2018),25 patients were adults with depression and/or anxiety who were reporting problems with their everyday life, without a history of severe somatic illness or psychosis. Shimada and colleagues published 3 papers on patients with SZ or schizoaffective disorders aged between 20 and 60 years who were newly hospitalized in a psychiatric hospital and discharged within 1 year. Patients with a diagnosis other than SZ or schizoaffective disorders, those with a history of cognitive delay, neurologic disorders, and/or significant drug or alcohol abuse, and patients with comorbid serious physical disorders were excluded from the study. Kim and colleagues (2020)23 conducted a prospective cohort study in clinically stable patients with SZ aged between 19 and 55 years. Patients had at least 2 years of SZ diagnosis, and those with a history of severe impairments in social, psychological, and/or personal function, a diagnosis of other mental illnesses, or auditory, visual, and/or language impairments were excluded from the study. In the prospective cohort study by Karaman and colleagues (2020)24 included patients with SZ aged between 18 and 65 years, without additional psychiatric illnesses, active use of alcohol or substances, and being in a recurrent period
Existing evidence had several limitations in response to the research questions of this review. We did not find any publications about the clinical effectiveness and cost-effectiveness of OT for the treatment of SUDs that met the inclusion criteria for our review. The evidence was also limited on the cost-effectiveness of OT for the treatment of MHCs. Specifically, the findings of this review are focused on the clinical effectiveness of OT for the treatment of MHCs limited to adult patients diagnosed with depression and/or anxiety, and SZ. In the primary studies included in this report, patients were excluded if they had concurrent MHCs or SUDs. Although excluding patients with other accompanying conditions may be part of the study design in health research, there is a substantial overlap in MHCs and SUDs in clinical practice that should be taken into account