1
|
Kwon S, Firth J, Joshi D, Torous J. Accessibility and availability of smartphone apps for schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:98. [PMID: 36385116 PMCID: PMC9668219 DOI: 10.1038/s41537-022-00313-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/05/2022] [Indexed: 05/25/2023]
Abstract
App-based interventions have the potential to enhance access to and quality of care for patients with schizophrenia. However, less is known about the current state of schizophrenia apps in research and how those translate to publicly available apps. This study, therefore, aimed to review schizophrenia apps offered on marketplaces and research literature with a focus on accessibility and availability. A search of recent reviews, gray literature, PubMed, and Google Scholar was conducted in August 2022. A search of the U.S. Apple App Store and Google Play App Store was conducted in July 2022. All eligible studies and apps were systematically screened/reviewed. The academic research search produced 264 results; 60 eligible studies were identified. 51.7% of research apps were built on psychosis-specific platforms and 48.3% of research apps were built on non-specific platforms. 83.3% of research apps offered monitoring functionalities. Only nine apps, two designed on psychosis-specific platforms and seven on non-specific platforms were easily accessible. The search of app marketplaces uncovered 537 apps; only six eligible marketplace apps were identified. 83.3% of marketplace apps only offered psychoeducation. All marketplace apps lacked frequent updates with the average time since last update 1121 days. There are few clinically relevant apps accessible to patients on the commercial marketplaces. While research efforts are expanding, many research apps are unavailable today. Better translation of apps from research to the marketplace and a focus on sustainable interventions are important targets for the field.
Collapse
Affiliation(s)
- Sam Kwon
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Devayani Joshi
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| |
Collapse
|
2
|
An ambivalent atmosphere: Employment training programs and mental health recovery. Health Place 2020; 62:102266. [PMID: 32479351 DOI: 10.1016/j.healthplace.2019.102266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/14/2019] [Accepted: 12/02/2019] [Indexed: 11/23/2022]
Abstract
This article critically examines the role of employment training programs in the personal recovery of adults living with mental illness in community settings. Using Cameron Duff's (2014) notion of 'assemblages of recovery,' we explore how, and to what extent, employment training programs provide the supportive resources linked to personal recovery. Using an ethnographic case study, we describe the ambivalent atmospheres associated with one program. This ambivalence expresses the fundamental tension between the genuine aspirations of personal recovery and the realities of the capitalist labor process.
Collapse
|
3
|
Miralles I, Granell C, Díaz-Sanahuja L, Van Woensel W, Bretón-López J, Mira A, Castilla D, Casteleyn S. Smartphone Apps for the Treatment of Mental Disorders: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e14897. [PMID: 32238332 PMCID: PMC7163422 DOI: 10.2196/14897] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/05/2019] [Accepted: 01/20/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Smartphone apps are an increasingly popular means for delivering psychological interventions to patients suffering from a mental disorder. In line with this popularity, there is a need to analyze and summarize the state of the art, both from a psychological and technical perspective. OBJECTIVE This study aimed to systematically review the literature on the use of smartphones for psychological interventions. Our systematic review has the following objectives: (1) analyze the coverage of mental disorders in research articles per year; (2) study the types of assessment in research articles per mental disorder per year; (3) map the use of advanced technical features, such as sensors, and novel software features, such as personalization and social media, per mental disorder; (4) provide an overview of smartphone apps per mental disorder; and (5) provide an overview of the key characteristics of empirical assessments with rigorous designs (ie, randomized controlled trials [RCTs]). METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed. We performed searches in Scopus, Web of Science, American Psychological Association PsycNET, and Medical Literature Analysis and Retrieval System Online, covering a period of 6 years (2013-2018). We included papers that described the use of smartphone apps to deliver psychological interventions for known mental disorders. We formed multidisciplinary teams, comprising experts in psychology and computer science, to select and classify articles based on psychological and technical features. RESULTS We found 158 articles that met the inclusion criteria. We observed an increasing interest in smartphone-based interventions over time. Most research targeted disorders with high prevalence, that is, depressive (31/158,19.6%) and anxiety disorders (18/158, 11.4%). Of the total, 72.7% (115/158) of the papers focused on six mental disorders: depression, anxiety, trauma and stressor-related, substance-related and addiction, schizophrenia spectrum, and other psychotic disorders, or a combination of disorders. More than half of known mental disorders were not or very scarcely (<3%) represented. An increasing number of studies were dedicated to assessing clinical effects, but RCTs were still a minority (25/158, 15.8%). From a technical viewpoint, interventions were leveraging the improved modalities (screen and sound) and interactivity of smartphones but only sparingly leveraged their truly novel capabilities, such as sensors, alternative delivery paradigms, and analytical methods. CONCLUSIONS There is a need for designing interventions for the full breadth of mental disorders, rather than primarily focusing on most prevalent disorders. We further contend that an increasingly systematic focus, that is, involving RCTs, is needed to improve the robustness and trustworthiness of assessments. Regarding technical aspects, we argue that further exploration and innovative use of the novel capabilities of smartphones are needed to fully realize their potential for the treatment of mental health disorders.
Collapse
Affiliation(s)
| | | | | | | | - Juana Bretón-López
- Universitat Jaume I, Castellón de la Plana, Spain
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, Castellón, Spain
| | - Adriana Mira
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Diana Castilla
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, Castellón, Spain
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | | |
Collapse
|
4
|
Fortuna KL, Venegas M, Umucu E, Mois G, Walker R, Brooks JM. The Future of Peer Support in Digital Psychiatry: Promise, Progress, and Opportunities. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2019; 6:221-231. [PMID: 33796435 PMCID: PMC8011292 DOI: 10.1007/s40501-019-00179-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE This selective review highlights promising findings and future opportunities relevant to digital peer support services. This review considered literature published in peer-reviewed scholarly journals within the past 36 months. RECENT FINDINGS Digital peer support spans multiple technology modalities: peer-delivered and smartphone-supported interventions, peer-supported asynchronous technology, artificial peer support, informal peer-to-peer support via social media, video games, and virtual worlds. Digital peer support is an emerging area of research that shows promise in improving mental health symptoms, medical and psychiatric self-management skill development, social functioning, hope, and empowerment. SUMMARY As the science of peer support in digital psychiatry advances, peer support specialists will likely have an increasingly important role in the mental health workforce-from providing evidence-based, fidelity-adherent interventions to expanding their reach to vulnerable populations and communities.
Collapse
Affiliation(s)
- Karen L. Fortuna
- The Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH, 03301, USA
| | - Maria Venegas
- CDC Health Promotion Research Center at Dartmouth, Lebanon, NH, 03766, USA
| | - Emre Umucu
- Department of Rehabilitation Sciences, University of Texas at El Paso, 500 W University Ave, El Paso, TX, 79968, USA
| | - George Mois
- School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA
| | - Robert Walker
- Massachusetts Department of Mental Health, 25 Staniford St, Boston, MA, 02114, USA
| | - Jessica M. Brooks
- Geriatric Research, Education, and Clinical Center, James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY, 10468, USA
| |
Collapse
|
5
|
Naslund JA, Aschbrenner KA. Digital technology for health promotion: opportunities to address excess mortality in persons living with severe mental disorders. EVIDENCE-BASED MENTAL HEALTH 2019; 22:17-22. [PMID: 30559332 PMCID: PMC6359972 DOI: 10.1136/ebmental-2018-300034] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/31/2018] [Accepted: 11/21/2018] [Indexed: 12/24/2022]
Abstract
Persons with severe mental disorders (SMDs) experience dramatically reduced life expectancy compared with the general population. We consider the role of digital technologies for addressing this serious public health concern. In this clinical review, we apply the multilevel risk model recently introduced by the WHO to conceptualise how digital technology can support efforts to reduce excess mortality risk at the individual, health system and social determinants of health levels. In particular, digital technologies show promise for targeting preventable physical health conditions in persons with SMDs. However, evidence on the use of these technologies for addressing early mortality risk factors is lacking. At the individual level, digital interventions show promise for managing mental health symptoms, promoting healthy lifestyle behaviours and targeting substance use concerns. At the health system level, digital interventions can support care coordination, clinician training, screening and monitoring health indices and shared decision-making. At the social determinants of health level, digital interventions can facilitate opportunities to engage peers for illness self-management and health promotion and for delivering and/or augmenting supported employment programmes. The time is ripe to capitalise on early evidence to support future development, testing and delivery of effective digital efforts targeting risk factors that contribute to shorter life expectancy in persons with SMDs. Key challenges and opportunities for future research include increasing user engagement, involving users during development and testing of digital interventions, carefully considering risks/harms and rigorously evaluating effectiveness and costs to support the scalability and sustainability of promising digital approaches.
Collapse
Affiliation(s)
- John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly A Aschbrenner
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| |
Collapse
|
6
|
Latulippe K, Provencher V, Boivin K, Vincent C, Guay M, Kairy D, Morales E, Pellerin MA, Giroux D. Using an Electronic Tablet to Assess Patients' Home Environment by Videoconferencing Prior to Hospital Discharge: Protocol for a Mixed-Methods Feasibility and Comparative Study. JMIR Res Protoc 2019; 8:e11674. [PMID: 31344677 PMCID: PMC6682277 DOI: 10.2196/11674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 01/28/2023] Open
Abstract
Background Occupational therapists working in hospitals are usually involved in discharge planning to assess patients’ safety and autonomy upon returning home. However, their assessment is usually done at the hospital due to organizational and financial constraints. The lack of visual data about the patients’ home may thus reduce the appropriateness and applicability of the support recommended upon discharge. Although various technological tools such as mobile devices (mobile health) are promising methods for home-based distance assessment, their application in hospital settings may raise several feasibility issues. To our knowledge, their usefulness and added value compared to standard procedure have not been addressed yet in previous studies. Moreover, several feasibility issues need to be explored. Objective This paper aims to (1) document the clinical feasibility of using an electronic tablet to assess the patient's home environment by mobile videoconferencing and (2) explore the added value of using mobile videoconferencing, compared to the standard procedure. Methods A feasibility and comparative study using a mixed-methods (convergent) design is currently undergoing. Six occupational therapists will assess the home environment of their patients in the hospital setting: they will first perform a semistructured interview (a) and then use mobile videoconferencing (b) to compare “a versus a+b.” Interviews with occupational therapists and patients and their caregivers will further explore the advantages and disadvantages of mobile videoconferencing. Two valid tools are used (the Canadian Measure of Occupational Performance and the telehealth responsivity questionnaire). Direct and indirect time is also collected. Results The project was funded in the spring of 2016 and authorized by the ethics committee in February 2017. Enrollment started in April 2017. Five triads (n=4 occupational therapists, n=5 clients, n=5 caregivers) have been recruited until now. The experiment is expected to be completed by April 2019 and analysis of the results by June 2019. Conclusions Mobile videoconferencing may be a familiar and easy solution for visualizing environmental barriers in the home by caregivers and clinicians, thus providing a promising and inexpensive option to promote a safe return home upon hospital discharge, but clinical feasibility and obstacles to the use of mobile videoconferencing must be understood. International Registered Report Identifier (IRRID) DERR1-10.2196/11674
Collapse
Affiliation(s)
- Karine Latulippe
- Center of Excellence on Aging Quebec, Quebec, QC, Canada.,Department of Teaching and Learning Studies, Université Laval, Quebec, QC, Canada
| | - Véronique Provencher
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center for Research on Aging, Sherbrooke, QC, Canada
| | - Katia Boivin
- CHU de Québec-Université Laval, Quebec, QC, Canada
| | - Claude Vincent
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Manon Guay
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center for Research on Aging, Sherbrooke, QC, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Metropolitan Montreal, Montréal, QC, Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Marc-André Pellerin
- CHU de Québec-Université Laval, Quebec, QC, Canada.,Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Dominique Giroux
- Center of Excellence on Aging Quebec, Quebec, QC, Canada.,Department of Rehabilitation, Université Laval, Quebec, QC, Canada
| |
Collapse
|
7
|
Darvish A, Khodadadi-Hassankiadeh N, Abdoosti S, Ghapandar Kashani M. Effect of Text Messaging-based Psychiatric Nursing Program on Quality of Life in Veterans with Post-Traumatic Stress Disorder: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2019. [PMID: 30643833 PMCID: PMC6311209 DOI: 10.30476/ijcbnm.2019.40846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recurrent post-traumatic stress disorder (PTSD) can devastate the life of a veteran. Despite the widespread use of mobile learning technology in health care and nursing, few studies have examined its potential in PTSD patients and the effect on quality of life (QoL). The present study aimed to investigate the effect of a text messaging-based psychiatric nursing program on QoL in veterans with PTSD symptoms. METHODS A single-blinded, randomized, controlled trial was conducted at the outpatient clinic of Sadr Hospital in Tehran (Iran) from January 2014 to October 2015. A total of 98 veterans with PTSD who referred to the outpatient clinic of the hospital were initially assessed for eligibility to participate in the study. Based on the inclusion criteria, 66 veterans were recruited in the study and randomly allocated to a control group (n=33) and an intervention group (n=33). Due to the lost to follow-up, 9 participants (control=4, intervention=5) were excluded from the analysis phase. The intervention group received psychiatric support via short text messages for 6 months, whereas the control group received the routine hospital care. The self-rating scale for PTSD (SRS-PTSD) and the short form 36 (SF-36) were used to evaluate the severity of symptoms and the QoL, respectively. The results were analyzed using the SPSS software (version 18.0) with the Chi-square test, Fisher's exact test, independent sample t test, and paired sample t test. P<0.05 was considered statistically significant. RESULTS A significant improvement in PTSD (P=0.001) and QoL (P=0.001) was observed in the intervention group compared to the control group. Moreover, the recurrence frequency in the intervention group was significantly lower (P=0.03). CONCLUSION The text messaging-based psychiatric nursing program reduced the severity of symptoms in veterans with PTSD and improved their QoL. Trial Registration Number: IRCT2013101214983N1.
Collapse
Affiliation(s)
- Asieh Darvish
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Naema Khodadadi-Hassankiadeh
- Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran
,Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Mojgan Ghapandar Kashani
- Department of Psychiatry, Sadr Hospital, Foundation of Martys and Veterans Affairs, Tehran, Iran
| |
Collapse
|
8
|
Nicholson J, Wright SM, Carlisle AM, Sweeney MA, McHugo GJ. The WorkingWell Mobile Phone App for Individuals With Serious Mental Illnesses: Proof-of-Concept, Mixed-Methods Feasibility Study. JMIR Ment Health 2018; 5:e11383. [PMID: 30361199 PMCID: PMC6231827 DOI: 10.2196/11383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The disparities in employment for individuals with serious mental illnesses have been well documented, as have the benefits of work. Mobile technology can provide accessible in-the-moment support for these individuals. The WorkingWell mobile app was developed to meet the need for accessible follow-along supports for individuals with serious mental illnesses in the workplace. OBJECTIVE We explore the usability, usage, usefulness, and overall feasibility of the WorkingWell mobile app with individuals with serious mental illnesses who are actively employed and receiving community-based services. METHODS In this proof-of-concept, mixed-methods, 2-month feasibility study (N=40), employed individuals with serious mental illnesses were recruited in mental health agencies. Participants completed surveys regarding background characteristics and cellphone use at enrollment and responded to interview items regarding app usability, usage, and usefulness in technical assistance calls at 1, 2, 4, and 6 weeks of participation and in the exit interview at 8 weeks. Data on the frequency of app usage were downloaded on a daily basis. A version of the System Usability Scale (SUS) was administered in the exit interview. Overall feasibility was determined by the percent of users completing the study, responses to an interview item regarding continued use, and findings on usability, usage, and usefulness. General impressions were obtained from users regarding user support materials, technical assistance, and study procedures. RESULTS Most participants were male (60%, 24/40), aged 55 or younger (70%, 28/40), white (80%, 32/40), had less than a 4-year college education (78%, 31/40), were employed part-time (98%, 39/40), had been working more than 6 months (60%, 24/40), and indicated a diagnosis of bipolar, schizoaffective, or depressive disorder (84%, 16/25). The majority of participants owned cellphones (95%, 38/40) and used them multiple times per day (83%, 33/40). Their average rating on SUS usability items was 3.93 (SD 0.77, range 1.57-5.00), reflecting positive responses. In general, participants indicated WorkingWell was "very easy," "straightforward," "simple," and "user friendly." Usability challenges were related to personal issues (eg, memory) or to difficulties with the phone or app. Data on app usage varied considerably. The most frequent navigations were to the home screen, followed by Rate My Day and My Progress, and then by Manage the Moment and Remind Me. The app was described as useful by most participants; 86% (30/35) agreed the app would help them manage better on the job. Of the 40 original participants, 35 (87%) completed the study. CONCLUSIONS The WorkingWell app is a feasible approach to providing accessible, as-needed employment support for individuals with serious mental illnesses. The app would benefit from modifications to address recommendations from feasibility testing. Controlled research with larger samples, more diverse in individual characteristics and workplace settings, is essential to demonstrating the effectiveness of the app.
Collapse
Affiliation(s)
- Joanne Nicholson
- Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Spenser M Wright
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Alyssa M Carlisle
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Mary Ann Sweeney
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Gregory J McHugo
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| |
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW The purpose of this update is to provide an overview of the breadth of research studies published from April 2017 to April 2018 on mobile-based interventions for mental health, with a special emphasis on smartphone-based interventions. RECENT FINDINGS Several studies during the review period have described the process of applying user-centred design in the development of mental health apps and novel approaches to enhance user-engagement. Studies on consumer perspectives indicate largely positive findings about open-ness to utilize mental health apps. There is a scarcity of similar studies on health providers. Efficacy studies have provided evidence for apps for a variety of psychiatric disorders. There are fewer studies on preventive and promotive interventions. Although a plethora of mental health apps is available for public, most have not undergone scientific evaluation. Many well researched apps are not accessible to public. The potential of smartphone technology in enhancing healthcare service delivery in low-resource settings has also been examined in a few studies. SUMMARY Evidence for acceptability, feasibility and efficacy of mobile-based mental health interventions for facilitating recovery is on the rise. More research is needed on implementation and integration of these interventions in diverse real-world clinical and community contexts.
Collapse
|