Feasibility and Acceptability of Using a Mobile Phone App for Characterizing Auditory Verbal Hallucinations in Adolescents With Early-Onset Psychosis: Exploratory Study

Abstract

Background Auditory verbal hallucinations (AVH) are the most frequent symptom in early-onset psychosis (EOP) and a risk factor for increased suicide attempts in adolescents. Increased knowledge of AVH characteristics can lead to better prediction of risk and precision of diagnosis and help identify individuals with AVH who need care. As 98% of Norwegian adolescents aged 12 to 16 years own a mobile phone, the use of mobile phone apps in symptom assessment and patient communication is a promising new tool. However, when introducing new technology to patients, their subjective experiences are crucial in identifying risks, further development, and potential integration into clinical care. Objective The objective was to explore the feasibility and acceptability of a newly developed mobile phone app in adolescents with EOP by examining compliance with the app and user experiences. Indication of validity was explored by examining associations between AVH dimensions, which were correlated and analyzed. Methods Three adolescents with EOP and active AVH were enrolled. Real-time AVH were logged on an iPod touch using the experience sampling method (ESM), for seven or more consecutive days. The app included five dimensions of AVH characteristics and was programmed with five daily notifications. Feasibility and acceptability were examined using the mean response rate of data sampling and by interviewing the participants. Validity was assessed by examining associations between the AVH dimensions using nonparametric correlation analysis and by visual inspection of temporal fluctuations of the AVH dimensions. Results One participant was excluded from the statistical analyses but completed the interview and was included in the examination of acceptability. The sampling period of the two participants was mean 12 (SD 6) days with overall completed sampling rate of 74% (SD 30%), indicating adequate to high compliance with the procedure. The user experiences from the interviews clustered into four categories: (1) increased awareness, (2) personal privacy, (3) design and procedure, and (4) usefulness and clinical care. One participant experienced more commenting voices during the sampling period, and all three participants had concerns regarding personal privacy when using electronic devices in symptom assessment. The AVH dimensions of content, control, and influence showed moderate to strong significant correlations with all dimensions ( P <.001). Days of data sampling showed weak to moderate correlations with localization ( P <.001) and influence ( P =.03). Visual inspection indicated that the app was able to capture fluctuations within and across days for all AVH dimensions. Conclusions This study demonstrates the value of including patients’ experiences in the development and pilot-testing of new technology. Based on the...

Smartphone Apps to Support Coordinated Specialty Care for Prodromal and Early Course Schizophrenia Disorders: Systematic Review

“…Smelror et al [25] conducted an exploratory study for 7 days by using an app to assist patients with early onset psychosis to cope with their auditory verbal hallucinations. Of the four patients contacted to participate in the study, one refused and one was excluded from the statistical analyses due to poor compliance.…”

Security and Privacy of mHealth Applications: A Scoping Review

“…For each database, the titles and abstracts of every article were searched for following keywords: "health", "app" OR "application", "security" OR "privacy" 4 . The search was performed on the 6th of August, 2019 and covered research Full Scopus database, not restricted to the medical category 2 65 ACM sources in Scopus 3 329 IEEE sources in Scopus 4 Full search queries used in this scoping review are presented in the Appendix articles written in English and published between April 2016 5 and August 2019. Given the rapid growth and development of the mHealth application space in recent years, we wished to focus on recent literature and the current regulatory landscape.…”

“…7 Some of the papers are included in multiple categories due to an overlap in contributions 8 4 of those papers (4/37) were defined as models Next, we discuss the health conditions covered in the included papers, followed by the privacy and security regulations that they refer to. [6], [8], [17], [22], [23], [27], [41], [51]- [68] General focus (n=18) [2], [21], [24] [3], [4], [12], [76], [80], [81], [92], [96]- [110] S/P focused design features and recommendations (n=16) [7], [25], [28], [51], [54], [57], [59], [66], [93]- [95], [111]- [114] 1) Target health conditions…”

“…Studies covered a wide range of mental health conditions, which included stress [3], depression [55], [60], [71], sleep disorders [88], smoking cessation [55], [98], psychosis [4], anxiety [53], and cognitive decline such as dementia [58], [65]. Studies also addressed specific mental health interventions, such as cognitive behavioural therapy (CBT) or behavioural activation (BA) for depression [71] and behaviour change [41], eye movement desensitization and reprocessing (EMDR) [70], and mood tracking [56].…”

“…T HERE is a growing body of literature that recognises the potential of mobile applications (apps) to improve access to healthcare and provide real-time monitoring and self-management of various health conditions [1]- [3]. For instance, mHealth apps have become popular resources for mental health support as an accessible alternative or adjunct to face-to-face therapy [4]. They are increasingly widely used, both independently and following the recommendation of health professionals [5].…”