Purpose of Review We present a review of recent methods of objective measurement in psychiatry and psychology with a focus on home monitoring and its utility in guiding treatment. Recent Findings For individualized diagnostics and treatment of insomnia, actigraphy can generate clinically useful graphical presentations of sleep timing and patterns. Psychophysiological measures may complement psychometrics by tracking parallel changes in physiological responses and emotional functioning, especially during therapy for trauma symptoms and emotion regulation. It seems that rather than defining universal cut-offs, an individualised range of variability could characterize treatment response. Summary Wearable actigraphy and psychophysiological sensors are promising devices to provide biofeedback and guide treatment. Use of feasible and reliable technology during experimental and clinical procedures may necessitate defining healthy and abnormal responses in different populations and pathological states. We present a “call for action” towards further collaborative work to enable large scale use of objective measures.

Recently, this journal published an article by Sariaslan, Leucht, Zetterqvist, Lichtenstein, and Fazel (2021), which describes a cohort of individuals prescribed antipsychotics in Sweden between 2005 and 2013. The authors provide a methodologically rigorous study with a large sample (n = 74 925) from several national databases that control for time-invariant confounders (e.g. demographic characteristics). They conclude that periods of absence of antipsychotic prescription among individuals with psychotic disorders are associated with higher rates of arrests and convictions (Sariaslan et al., 2021). We applaud Sariaslan et al. for their clever study design but have several concerns and questions about the motives and message of the paper. We found that they did not sufficiently cover the complex background of literature on antipsychotic prescription, which weakens their supposition of covering time-invariant factors. Their broadly defined constructs, such as 'crime rates', also seemed misleading. They furthermore may stigmatize mental illness by promoting antipsychotics as a criminogenic intervention.For one, the paper concludes that antipsychotics may effectively reduce arrests and convictions in patients with psychotic disorders. However, they ignore important social and environmental factors that confound these conclusions. For instance, a foundational study in the World Journal of Psychiatry (Schwartz & Blankenship, 2014) established that Black and African American healthcare consumers are diagnosed with psychotic disorders at a rate three or four times higher than White consumerswith a similar trend for immigrants In Sweden, these findings hold; Black citizens and immigrants receive psychotic disorder diagnoses at a higher rate and are more likely to be compulsorily admitted (e.g. Al-Saffar, Borga, Wicks, & Hallstrom, 2004). The racial bias in the mental health system and policing puts into question both the ecological validity and implications of the observed betweenperson associations. The current climate in Sweden regarding race and immigration is also an important consideration. Some believe that immigrants increase crimethough they have decreasing rates of crime and face several challenges integrating into society (Vasiljevic, Svensson, & Shannon, 2020). Thus, these researchers had a crucial task to carefully consider the literature as not to advance stereotypes or prejudices.Sariaslan et al. also seem to causally link the use of individual antipsychotics to decreasing arrests and convictions. Nevertheless, this study is observational and only associations are present. The study does not account for several time-variant covariates such as vulnerability/medical delay situations linked to the absence of prescription. Equally, some analyses appear underpowered (e.g. clozapine's association with arrests and convictions). Despite these limitations, the authors infer causation, discussing potential mechanisms of individual antipsychotics such as clozapine. Sariaslan et al. even suggest that these associations ...

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