Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In this systematic review, religion-based spirituality was found to be an important factor in the recovery of people with schizophrenia (PWS) in Southeast Asia.

2. Furthermore, other elements of the Connection, Hope, Identity, Meaning, and Empowerment (CHIME) recovery model, such as identity, stigma, and hope, were found to play a role in mental health recovery for PWS in Southeast Asia.

Evidence Rating Level: 1 (Excellent)

People with schizophrenia (PWS) living in Southeast Asia may recover better from their illness when the focus is placed on elements such as spiritual and culture-specific factors, rather than biomedical factors. Presently, there is limited evidence on mental health recovery of this patient population. As a result, the objective of the present systematic review was to investigate the mental health practices and their alignment with the Connection, Hope, Identity, Meaning, and Empowerment (CHIME) recovery model in PWS living in Southeast Asia.

Of 842 identified records, 31 studies were included from various databases from 2004 to January 2021. Studies were included if they were written in English, conducted on adults in Southeast Asia, and evaluated a response of PWS to their condition during or after treatment. Studies were excluded if they did not focus on patients diagnosed with schizophrenia, or if they were conducted in Singapore, as Singapore is classified as a developed country and is distinct from other Southeast Asian countries. The review was performed using PRISMA guidelines. The Critical Appraisals Skills Programme (CASP) tools were used for quality assessment. The primary outcome was to identify factors associated with mental health recovery in PWS in Southeast Asia and how they align with the CHIME recovery model.

The results demonstrated that overall, religiosity and spirituality aided in mental health recovery. For instance, having a religious affiliation and being part of a religious community lowered distress and was seen as a positive coping mechanism through actions such as prayer, meditation, or reading scripture. Furthermore, other elements such as identity, stigma, and hope were found to play a role in the recovery of PWS in Southeast Asia. Despite these results, the study was limited by the exclusion of languages other than English which may have limited the comprehensiveness of the review. Nonetheless, the present study demonstrated that PWS in Southeast Asia require culturally specific approaches that align with the CHIME recovery model for mental health recovery.

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