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Review
. 2024 Sep 30:11:e57150.
doi: 10.2196/57150.

Leveraging Personal Technologies in the Treatment of Schizophrenia Spectrum Disorders: Scoping Review

Affiliations
Review

Leveraging Personal Technologies in the Treatment of Schizophrenia Spectrum Disorders: Scoping Review

Jessica D'Arcey et al. JMIR Ment Health. .

Abstract

Background: Digital mental health is a rapidly growing field with an increasing evidence base due to its potential scalability and impacts on access to mental health care. Further, within underfunded service systems, leveraging personal technologies to deliver or support specialized service delivery has garnered attention as a feasible and cost-effective means of improving access. Digital health relevance has also improved as technology ownership in individuals with schizophrenia has improved and is comparable to that of the general population. However, less digital health research has been conducted in groups with schizophrenia spectrum disorders compared to other mental health conditions, and overall feasibility, efficacy, and clinical integration remain largely unknown.

Objective: This review aims to describe the available literature investigating the use of personal technologies (ie, phone, computer, tablet, and wearables) to deliver or support specialized care for schizophrenia and examine opportunities and barriers to integrating this technology into care.

Methods: Given the size of this review, we used scoping review methods. We searched 3 major databases with search teams related to schizophrenia spectrum disorders, various personal technologies, and intervention outcomes related to recovery. We included studies from the full spectrum of methodologies, from development papers to implementation trials. Methods and reporting follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

Results: This search resulted in 999 studies, which, through review by at least 2 reviewers, included 92 publications. Included studies were published from 2010 to 2023. Most studies examined multitechnology interventions (40/92, 43%) or smartphone apps (25/92, 27%), followed by SMS text messaging (16/92, 17%) and internet-based interventions (11/92, 12%). No studies used wearable technology on its own to deliver an intervention. Regarding the stage of research in the field, the largest number of publications were pilot studies (32/92, 35%), followed by randomized control trials (RCTs; 20/92, 22%), secondary analyses (16/92, 17%), RCT protocols (16/92, 17%), development papers (5/92, 5%), and nonrandomized or quasi-experimental trials (3/92, 3%). Most studies did not report on safety indices (55/92, 60%) or privacy precautions (64/92, 70%). Included studies tend to report consistent positive user feedback regarding the usability, acceptability, and satisfaction with technology; however, engagement metrics are highly variable and report mixed outcomes. Furthermore, efficacy at both the pilot and RCT levels report mixed findings on primary outcomes.

Conclusions: Overall, the findings of this review highlight the discrepancy between the high levels of acceptability and usability of these digital interventions, mixed efficacy results, and difficulties with sustained engagement. The discussion highlights common patterns that may underscore this observation in the field; however, as this was a scoping review, a more in-depth systematic review or meta-analysis may be required to better understand the trends outlined in this review.

Keywords: acceptability; access to specialized resources; care; clinical integration; database; digital health; digital mental health; eHealth; efficacy; engagement; feasibility; health technology; mental health; mental health care; mobile phone; mood disorder; mood disorders; neurodevelopment; personal technology; satisfaction; schizophrenia; schizophrenia spectrum disorder; scoping review; specialized care; support; technology; text; text messaging; usability; user feedback.

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Conflict of interest statement

Conflicts of Interest: JT is the editor in chief of JMIR Mental Health. Research examining the App4Independence (A4i) is included in this review. A4i was developed and owned by the joint for-profit venture A4i. A4i is jointly owned by MEMOTEXT, the Centre for Addiction and Mental Health, and SK – hence having author engagement in this company.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) breakdown of search results. Description of the review process that determined the included and excluded studies.
Figure 2
Figure 2
Number of publications over time by technological modality.

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