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Lane E, D'Arcey J, Kidd S, Onyeaka H, Alon N, Joshi D, Torous J. Digital Phenotyping in Adults with Schizophrenia: A Narrative Review. Curr Psychiatry Rep 2023; 25:699-706. [PMID: 37861979 DOI: 10.1007/s11920-023-01467-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE OF REVIEW As care for older adult patients with schizophrenia lacks innovation, technology can help advance the field. Specifically, digital phenotyping, the real-time monitoring of patients' behaviors through smartphone sensors and symptoms through surveys, holds promise as the method can capture the dynamicity and environmental correlates of disease. RECENT FINDINGS Few studies have used digital phenotyping to elucidate adult patients' experiences with schizophrenia. In this narrative review, we summarized the literature using digital phenotyping on adults with schizophrenia. No study focused solely on older adult patients. Studies including all adult patients were heterogeneous in measures used, duration, and outcomes. Despite limited research, digital phenotyping shows potential for monitoring outcomes such as negative, positive, and functional symptoms, as well as predicting relapse. Future research should work to target the symptomology persistent in chronic schizophrenia and ensure all patients have the digital literacy required to benefit from digital interventions and homogenize datasets to allow for more robust conclusions.
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Affiliation(s)
- Erlend Lane
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA
| | - Jessica D'Arcey
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sean Kidd
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Henry Onyeaka
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Massachusetts General/McLean Hospital, Boston, MA, USA
| | - Noy Alon
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA
| | - Devayani Joshi
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA
| | - John Torous
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02115, USA.
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Polillo A, Foussias G, Wong AHC, Ampofo A, Stergiopoulos V, Anderson KK, Bromley S, D'Arcey J, de Oliveira C, Duda L, Henderson J, Kidd S, Kurdyak P, Wang W, Zaheer J, Voineskos AN, Kozloff N. ED to EPI: protocol for a pragmatic randomised controlled trial of an SMS (text) messaging intervention to improve the transition from the emergency department to early psychosis intervention for young people with psychosis. BMJ Open 2020; 10:e042751. [PMID: 33334839 PMCID: PMC7747582 DOI: 10.1136/bmjopen-2020-042751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION While nearly half of all new psychotic disorders are diagnosed in the emergency department (ED), most young people who present to the ED with psychosis do not receive timely follow-up with a psychiatrist, and even fewer with evidence-based early psychosis intervention (EPI) services. We aim to test an intervention delivered using short message service (SMS), a low-cost, low-complexity, youth-friendly approach, to improve transitions from the ED to EPI services. METHODS AND ANALYSIS This is a protocol for a pragmatic randomised, single blind, controlled trial with accompanying economic and qualitative evaluations conducted at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. A consecutive series of 186 participants aged 16-29 referred by the ED to CAMH's EPI programme will be recruited for a trial of a two-way intervention involving reminders, psychoeducation and check-ins delivered via SMS. The primary outcome will be attendance at the first consultation appointment within 30 days of study enrolment assessed through chart reviews in the electronic health record. We will also extract routine clinical measures, including the Brief Psychiatric Rating Scale, Clinical Global Impression and Service Engagement Scale, and link with provincial health administrative data to examine system-level outcomes, including ED visits and psychiatric hospitalisations, 6 months and up to 2 years after baseline. We will perform a cost-effectiveness analysis of the primary study outcome and costs incurred, calculating an incremental cost effectiveness ratio. Web-based surveys and qualitative interviews will explore intervention user experience. Patients and families with lived experience will be engaged in all aspects of the project. ETHICS AND DISSEMINATION Research Ethics Board approval has been obtained. Findings will be reported in scientific journal articles and shared with key stakeholders including youth, family members, knowledge users and decision makers. TRIAL REGISTRATION NUMBER NCT04298450.
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Affiliation(s)
- Alexia Polillo
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - George Foussias
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Albert H C Wong
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Augustina Ampofo
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kelly K Anderson
- Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Sarah Bromley
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jessica D'Arcey
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Claire de Oliveira
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Lillian Duda
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Joanna Henderson
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sean Kidd
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wei Wang
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Kozloff
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Psychiatry, University of Toronto, Toronto, Ontario, Canada
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D'Arcey J, Collaton J, Kozloff N, Voineskos AN, Kidd SA, Foussias G. The Use of Text Messaging to Improve Clinical Engagement for Individuals With Psychosis: Systematic Review. JMIR Ment Health 2020; 7:e16993. [PMID: 32238334 PMCID: PMC7163420 DOI: 10.2196/16993] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/03/2020] [Accepted: 01/14/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Individuals experiencing psychosis are at a disproportionate risk for premature disengagement from clinical treatment. Barriers to clinical engagement typically result from funding constraints causing limited access to and flexibility in services. Digital strategies, such as SMS text messaging, offer a low-cost alternative to potentially improve engagement. However, little is known about the efficacy of SMS text messaging in psychosis. OBJECTIVE This review aimed to address this gap, providing insights into the relationship between SMS text messaging and clinical engagement in the treatment of psychosis. METHODS Studies examining SMS text messaging as an engagement strategy in the treatment of psychosis were reviewed. Included studies were published from the year 2000 onward in the English language, with no methodological restrictions, and were identified using 3 core databases and gray literature sources. RESULTS Of the 233 studies extracted, 15 were eligible for inclusion. Most studies demonstrated the positive effects of SMS text messaging on dimensions of engagement such as medication adherence, clinic attendance, and therapeutic alliance. Studies examining the feasibility of SMS text messaging interventions found that they are safe, easy to use, and positively received. CONCLUSIONS Overall, SMS text messaging is a low-cost, practical method of improving engagement in the treatment of psychosis, although efficacy may vary by symptomology and personal characteristics. Cost-effectiveness and safety considerations were not adequately examined in the studies included. Future studies should consider personalizing SMS text messaging interventions and include cost and safety analyses to appraise readiness for implementation.
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Affiliation(s)
- Jessica D'Arcey
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medial Science, University of Toronto, Toronto, ON, Canada
| | - Joanna Collaton
- Department of Clinical Psychology, University of Guelph, Guelph, ON, Canada
| | - Nicole Kozloff
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medial Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sean A Kidd
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medial Science, University of Toronto, Toronto, ON, Canada
| | - George Foussias
- Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Institute of Medial Science, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
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