SummaryThere is now an established evidence base for the use of information and communication technology (ICT) to support mental healthcare (‘e-mental health’) for common mental health problems. Recently, there have been significant developments in the therapeutic use of computers, mobile phones, gaming and virtual reality technologies for the assessment and treatment of psychosis. We provide an overview of the therapeutic use of ICT for psychosis, drawing on searches of the scientific literature and the internet and using interviews with experts in the field. We outline interventions that are already relevant to clinical practice, some that may become available in the foreseeable future and emerging challenges for their implementation.

Our preliminary results suggest that psychosocial outcome in schizophrenia may be affected by different factors. Longer history of psychotic episodes emerged as the most significant determinant of poorer outcome while longer duration of untreated illness and older age at illness onset were also associated with detrimental effects. Our findings may reflect the combined influences of neurodevelopmental abnormalities, exposure to psychotropic medication and psychosocial interventions as well as the vicissitudes of natural aging processes embedded in a chronic mental illness.

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An inability to experience pleasure or a reduction in the ability to do so is a prominent feature of schizophrenia that is often included among the negative symptoms of the disorder. As a whole, dysfunction in the affective experience of pleasure in patients with schizophrenia is poorly understood and is mediated by a number of cognitive and emotional processes. Whilst there is evidence that patients with schizophrenia have an impaired ability to derive and experience pleasure from non-current tasks, there is some evidence that they report current pleasurable experiences similar to non-clinical control participants. Previous studies investigating anhedonia have a number of methodological shortcomings that fail to examine the impact of general symptomology on the ability to experience pleasure. This current study involved 55 adults meeting the criteria for a diagnosis of schizophrenia. We looked specifically at relationships between anhedonia and positive, negative and general symptomatology. The results support the notion that anhedonia may best be considered as a separate phenomenon from negative symptoms of schizophrenia and from related symptomatology. The implications of these findings are considered in relation to future treatment initiatives.

Purpose – There is an association between the diagnosis of a mental illness and violent behaviour. Individuals diagnosed with severe and enduring mental health difficulties who display violent behaviour have inferior treatment outcomes when compared with those who do not engage in violent behaviour. Violent behaviour within care settings impacts on general functioning, adherence to treatment plans, and inhibits wider recovery goals. The paper aims to discuss these issues. Design/methodology/approach – This research studied 95 inpatients with a primary diagnosis of severe mental illness, with and without a history of violence, and compared how levels of global functioning and risk impacted on recovery. Patients were divided into two groups: those with and without a previous or current history of violence. The two groups were compared on measures of global functioning, symptomatology, and risk at baseline and 12-month follow up. Findings – Both violent and non-violent groups showed increased global functioning over time, with no significant difference between the groups. Neither group showed significant reductions in risk over time. Patients in the violent group had significantly fewer prior and current symptoms of mental ill-health than non-violent individuals. Research limitations/implications – Despite evidence suggesting that historical or current violence leads to impaired outcomes amongst people with diagnoses of mental illness, the findings of this study suggest a history of violent behaviour was not a predictor of poor progress within inpatient settings. Practical implications – Disconfirming previous hypotheses, the paper suggests that in itself, violent behaviour does not always significantly impair outcomes for individuals diagnosed with mental illnesses, and that many other variables contribute to meaningful recovery. Originality/value – Whilst there are previous studies investigating outcomes for inpatients diagnosed with mental illness who have violent histories, there is a dearth of research comparing equivalent groups in the same facility over the same time period. This study directly compared inpatients with or without a history of violence in the same psychiatric rehabilitation settings.