Psychosocial Interventions for Older Adults With Severe Mental Illness: A Systematic Scoping Review and Meta-analysis

Abstract

Este artículo presenta una revisión sistemática y metaanálisis sobre intervenciones psicosociales dirigidas a adultos mayores (≥50 años) con enfermedades mentales graves (SMI). Se analizaron 16 estudios con un total de 884 participantes. Las intervenciones se centraron principalmente en la recuperación clínica, con escasa atención a la recuperación personal. El metaanálisis mostró un efecto moderado (ES=0.366, p<.0001) y baja heterogeneidad (I²=18.81%). Sin embargo, el 62.5% de los estudios presentaron riesgo medio o alto de sesgo. Se concluye que, aunque las intervenciones psicosociales mejoran los resultados clínicos, existe una carencia significativa en abordar dimensiones como la esperanza, la autodeterminación y el bienestar subjetivo. Se recomienda desarrollar intervenciones holísticas y sostenibles que integren tanto la recuperación clínica como la personal para mejorar la calidad de vida de esta población.

Background: Older adults with severe mental illness (SMI) experience complex rehabilitative needs that are often neglected in clinical and research settings. Psychosocial interventions are key to supporting recovery; however, evidence specific to this population remains fragmented. This scoping review and meta-analysis aims to synthesize available research on psychosocial interventions designed for older adults with SMI and evaluate their effectiveness.

Study Design: Following the Arksey and O’Malley framework and PRISMA-ScR guidelines, we conducted a comprehensive search across PubMed, PsycINFO, and Scopus for studies published between 2000 and 2023. Eligibility was based on the PICO framework, focusing on adults aged ≥ 50 with SMI. Data were extracted and analyzed using descriptive synthesis and meta-analytic techniques.

Study Results: Sixteen studies met the inclusion criteria, encompassing 884 participants. Interventions primarily targeted clinical recovery, with limited focus on aspects of personal recovery. Meta-analysis indicated a moderate overall effect size (ES = 0.366, P < .0001) with low heterogeneity (I2 = 18.81%). Quality assessment revealed that 62.5% of studies had medium to high risk of bias.

Conclusions: While psychosocial interventions show promise in improving clinical outcomes for older adults with SMI, there is a significant gap in addressing personal recovery dimensions. Future research should emphasize holistic, long-term interventions to enhance both clinical and personal recoveries.