Background: The efficacy of art therapy as an adjuvant treatment for schizophrenia remains inconclusive, and variation in the effects of art therapy on schizophrenia by the type of schizophrenia, severity of schizophrenia, type of art therapy, follow-up duration, or different populations has never been systematically assessed. The objective of this study is to systematically evaluate the effects of art therapy on schizophrenia and to determine whether there are some potential influencing factors affecting the effects of art therapy.Methods: Seven online databases will be searched from their inception until June 30, 2022. All the relevant randomized clinical trials (RCTs) comparing art therapy plus standardized treatment versus standardized treatment alone for schizophrenia will be selected and assessed for inclusion. The Cochrane risk-of-bias tool will be used to evaluate the methodological quality of the included RCTs. Review Manager 5.4 will be used to analyze all the data obtained. Mental health symptoms are defined as the primary outcome, and the secondary outcomes include the Global Assessment of Functioning score, quality of life, functional remission, and the level of self-esteem. Subgroup analyses will be performed based on the type of schizophrenia, severity of schizophrenia, type of art therapy, follow-up duration, or different populations.Results: The results will be published in a peer-reviewed journal.Conclusions: This updated systematic review and subgroup meta-analysis will evaluate the effects of art therapy as adjunctive treatment to standardized treatment in patients with schizophrenia and determine whether there are some potential confounding variables affecting the effects of art therapy on the outcomes of schizophrenia patients, thus strengthening the evidence base for the clinical application of this combination therapy for schizophrenia.

Review question / Objective: How are the effects of art therapy on schizophrenia? Condition being studied: Schizophrenia is a chronic and severely disabling mental disorder that is associated with impairments in cognitive, emotional and psychosocial functioning affecting the prospect of recovery. (Jablensky, 2010; Leucht, 2014). Information sources: A comprehensive literature search will be carried out by two independent researchers (XX Luo and J Wang). Published studies will be retrieved in common databases including PubMed, Web of Science, ClinicalTrials.gov, Cochrane Library, Embase, China National Knowledge Infrastructure(CNKI), Wanfang Databases, the Chinese Scientific Journal Database, the Chinese Science Citation Database, and the Chinese Biomedical Literature Database from inception to May 30, 2022. In addition, we will search and evaluate the relevant systematic reviews and meta-analyses to select the potential studies from their references. No trial is excluded due to publication status or language.