Feasibility of using a smartphone app to assess early signs, basic symptoms and psychotic symptoms over six months: a preliminary reportCitation formats

  • External authors:
  • Richard Emsley
  • Christine Barrowclough

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Feasibility of using a smartphone app to assess early signs, basic symptoms and psychotic symptoms over six months: a preliminary report. / Eisner, Emily; Bucci, Sandra; Berry, Natalie; Emsley, Richard; Barrowclough, Christine; Drake, Richard.

In: Schizophrenia Research., 2019.

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@article{4b581d02c9e94a4a99b944801b26570a,
title = "Feasibility of using a smartphone app to assess early signs, basic symptoms and psychotic symptoms over six months: a preliminary report",
abstract = "Background: Psychosis relapses are common, have profound adverse consequences for patients, and are costly to health services. ‘Early signs’ have been used to predict relapse, in the hope of prevention or mitigation, with moderate sensitivity and specificity. We investigated the feasibility and validity of adding ‘basic symptoms’ to conventional early signs and monitoring these using a smartphone app.Methods: Individuals (n=18) experiencing a relapse within the past year were asked to use a smartphone app (‘ExPRESS’) weekly for six months to report early signs, basic symptoms and psychotic symptoms. Above-threshold increases in app-reported psychotic symptoms prompted a telephone interview (PANSS positive items) to assess relapse.Results: Participants completed 65{\%} app assessments and 58{\%} telephone interviews. App items showed high concurrent validity with researcher-rated psychotic symptoms and basic symptoms over six months. There was excellent agreement between telephone call and face-to-face assessed psychotic symptoms. The primary relapse definition, based on telephone assessment and casenotes, compared well with a casenote-only definition but had better specificity. Mixed-effects models provided preliminary evidence of concurrent and predictive validity: early signs and basic symptoms were associated with most app-assessed psychotic symptom variables the same week and with a number of psychotic symptoms variables three weeks later; adding basic symptoms to early signs improved model fit in most of these cases.Conclusions: This is the first study to test a smartphone app for monitoring early signs and basic symptoms as putative relapse predictors. It demonstrates that weekly app-based monitoring is feasible, valid and acceptable over six months.",
keywords = "schizophrenia, psychosis, relapse, mHealth, telemedicine, smartphone",
author = "Emily Eisner and Sandra Bucci and Natalie Berry and Richard Emsley and Christine Barrowclough and Richard Drake",
year = "2019",
doi = "10.1016/j.schres.2019.04.003",
language = "English",
journal = "Schizophrenia Research.",
issn = "0920-9964",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Feasibility of using a smartphone app to assess early signs, basic symptoms and psychotic symptoms over six months: a preliminary report

AU - Eisner, Emily

AU - Bucci, Sandra

AU - Berry, Natalie

AU - Emsley, Richard

AU - Barrowclough, Christine

AU - Drake, Richard

PY - 2019

Y1 - 2019

N2 - Background: Psychosis relapses are common, have profound adverse consequences for patients, and are costly to health services. ‘Early signs’ have been used to predict relapse, in the hope of prevention or mitigation, with moderate sensitivity and specificity. We investigated the feasibility and validity of adding ‘basic symptoms’ to conventional early signs and monitoring these using a smartphone app.Methods: Individuals (n=18) experiencing a relapse within the past year were asked to use a smartphone app (‘ExPRESS’) weekly for six months to report early signs, basic symptoms and psychotic symptoms. Above-threshold increases in app-reported psychotic symptoms prompted a telephone interview (PANSS positive items) to assess relapse.Results: Participants completed 65% app assessments and 58% telephone interviews. App items showed high concurrent validity with researcher-rated psychotic symptoms and basic symptoms over six months. There was excellent agreement between telephone call and face-to-face assessed psychotic symptoms. The primary relapse definition, based on telephone assessment and casenotes, compared well with a casenote-only definition but had better specificity. Mixed-effects models provided preliminary evidence of concurrent and predictive validity: early signs and basic symptoms were associated with most app-assessed psychotic symptom variables the same week and with a number of psychotic symptoms variables three weeks later; adding basic symptoms to early signs improved model fit in most of these cases.Conclusions: This is the first study to test a smartphone app for monitoring early signs and basic symptoms as putative relapse predictors. It demonstrates that weekly app-based monitoring is feasible, valid and acceptable over six months.

AB - Background: Psychosis relapses are common, have profound adverse consequences for patients, and are costly to health services. ‘Early signs’ have been used to predict relapse, in the hope of prevention or mitigation, with moderate sensitivity and specificity. We investigated the feasibility and validity of adding ‘basic symptoms’ to conventional early signs and monitoring these using a smartphone app.Methods: Individuals (n=18) experiencing a relapse within the past year were asked to use a smartphone app (‘ExPRESS’) weekly for six months to report early signs, basic symptoms and psychotic symptoms. Above-threshold increases in app-reported psychotic symptoms prompted a telephone interview (PANSS positive items) to assess relapse.Results: Participants completed 65% app assessments and 58% telephone interviews. App items showed high concurrent validity with researcher-rated psychotic symptoms and basic symptoms over six months. There was excellent agreement between telephone call and face-to-face assessed psychotic symptoms. The primary relapse definition, based on telephone assessment and casenotes, compared well with a casenote-only definition but had better specificity. Mixed-effects models provided preliminary evidence of concurrent and predictive validity: early signs and basic symptoms were associated with most app-assessed psychotic symptom variables the same week and with a number of psychotic symptoms variables three weeks later; adding basic symptoms to early signs improved model fit in most of these cases.Conclusions: This is the first study to test a smartphone app for monitoring early signs and basic symptoms as putative relapse predictors. It demonstrates that weekly app-based monitoring is feasible, valid and acceptable over six months.

KW - schizophrenia

KW - psychosis

KW - relapse

KW - mHealth

KW - telemedicine

KW - smartphone

U2 - 10.1016/j.schres.2019.04.003

DO - 10.1016/j.schres.2019.04.003

M3 - Article

JO - Schizophrenia Research.

JF - Schizophrenia Research.

SN - 0920-9964

ER -