Using Digital Technology in the Treatment of Schizophrenia
Open accessAbstract
From web-based applications to mobile devices, digital technologies hold tremendous potential to facilitate the delivery of healthcare for mental disorders, including schizophrenia. These eHealth (ie, electronic health) tools are increasingly being used to assist consumers during the course of their illnesses, from the provision of the continuity of care to improving well-being.1 This makes sense due to the growing trends of digital tool usage in psychiatric samples. A survey of psychiatric patients (N = 320) recruited from different services across the United States found that the patients’ interest in using digital technologies such as smartphones to monitor mental health was as high as 70.6%.2 Of the 320 psychiatric patients surveyed, 80% had access to the internet, and 62.5% owned a smartphone.2 Indeed, digital technologies such as smartphone apps have been shown to be acceptable and feasible in individuals with psychosis.3 Clinicians can now consider how they can use particular digital tools to either augment or deliver treatments, eg, psychosocial interventions targeting motivation, or pharmacological interventions targeting medication adherence. Digital tools can be used either to provide an assessment, eg, capturing live mood states, or used within an intervention, eg, prompting the individual to activate adaptive coping strategies. Digital tools as interventions are not directly equivalent to being engaged with a therapist or clinician in real life. For example, clients may find it easier to report compliance to therapeutic home tasks set online by clinicians, coaches, or moderators, even if they had not completed them (eg, lower face-to-face accountability). On the other hand, digital platforms can provide a safe space (albeit temporarily) for individuals who are hesitant about engaging with their treatment team face-to-face. Digital interventions delivered in those with psychosis come with several limitations. First, when digital tools are not designed or implemented properly, it is plausible that it may fail or be slow in identifying patient risk (eg, relapse). As such, in-person assessments conducted prior to the commencement of a digital intervention can be beneficial. For example, useful information such as how the individual generally responds online or identifying their early warning signs can then be used to either tailor treatment and/or used to monitor their risk of relapse. Hence, digital tools should be developed to incorporate a safety protocol or algorithm designed to identify risk online (eg, sudden cessation of the tool, expression of distress within online forums may trigger a phone follow-up). Second, adherence rates to digital interventions have been found to vary from medium to low rates of adherence.4 Therefore, it is important to identify predictors of adherence to these digital tools in order to increase the benefits to consumers and service providers.4 Because people with psychosis often report loneliness, stigma, and discrimination,5 a digital intervention that can allow people to access evidence-based health information as well as also provide a safe online environment is highly valuable.6 This is especially crucial for young people with psychosis, who are particularly vulnerable to feeling socially isolated given their onset of psychosis occurs within crucial social developmental milestones.7 The study by Schlosser and colleagues8 illustrates both the promise and challenges of digital interventions for young people with psychosis. The authors found that individuals in PRIME reported improvements in components of the primary outcome, motivated behavior, and in the secondary outcomes of depression, defeatist beliefs, and self-efficacy as compared to wait list (WL) control. There were, however, no significant differences in positive or negative symptoms of psychosis, quality of life or functioning from baseline to post-trial or 3-month follow-up. There was also evidence that PRIME was acceptable and feasible to participants. Finally, all participants were recruited remotely, underscoring the potential reach of digital interventions, particularly for individuals who might not have access to Coordinated Specialty Care (CSC) programs for first-episode psychosis (FEP). This study also draws attention to the challenges of implementing digital interventions. First, it is important to consider how newly developed digital interventions fit with other treatments; can they serve as a means of augmenting state-of-the-art treatment such as CSC or should they focus on individuals who do not have access to or have been discharged from CSC? If the latter, they would fill in a critical gap in our mental health system. Second, the use of remote assessments likely leads to different pathways to care than seen in CSC (ie, self-referral vs family members). Thus, do self-referred clients participating in digital interventions differ from those who are receiving treatment in CSC? This issue para
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There is a need for reliable data in the application of digital technology in schizophrenia therapy.
“Lim and Penn [18], who studied the potential of the application of digital technology in schizophrenia therapy, have stressed the need for reliable data”
From A conversational artificial intelligence agent for a mental health care app: Evaluation study of its participatory design (2021) · cites this paper as [18]
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- Authors
- Lim, M. H., & Penn, D. L.
- Affiliations
- Swinburne University of Technology (AU)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Lim, Michelle H
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-06-07
- Volume
- 44
- Issue
- 5
- Pages
- 937-938
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC6101527
- OpenAlex
- W2806002040
- Cited by
- 23
- References
- 10
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 4
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Schizophrenia Bulletin (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- UNC Libraries
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- schizophrenia, psychosis
- MeSH terms
- Humans, Psychotic Disorders, Schizophrenia, Telemedicine
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