Relapse in schizophrenia: Definitively not a bolt from the blue

Detecting relapse in youth with psychotic disorders utilizing patient-generated and patient-contributed digital data from Facebook

“…We identified significantly increased use of words belonging to the swear, anger, and negative emotion categories in the period of time preceding a relapse hospitalization consistent with escalating irritability and depression known to be associated with emerging relapse. 50,71 We also found increased use of words belonging to the hear and feel categories in the month preceding a relapse hospitalization, consistent with emerging perceptual disturbances, commonly experienced by individuals with psychosis. 50,51,71 This is also consistent with prior work in those at risk for developing psychosis, suggesting that words related to auditory perception, such as voices and sounds, predicted conversion to psychosis.…”

“…50,71 We also found increased use of words belonging to the hear and feel categories in the month preceding a relapse hospitalization, consistent with emerging perceptual disturbances, commonly experienced by individuals with psychosis. 50,51,71 This is also consistent with prior work in those at risk for developing psychosis, suggesting that words related to auditory perception, such as voices and sounds, predicted conversion to psychosis. 62 Consistent with prior studies, we found increased use of first-person pronouns, 59,63 but also second-person pronouns, which may be indicative of changes in the way an individual thinks about him/herself in relation to others, in-line with the social changes prominent in individuals experiencing worsening symptoms of psychosis.…”

“…62 Consistent with prior studies, we found increased use of first-person pronouns, 59,63 but also second-person pronouns, which may be indicative of changes in the way an individual thinks about him/herself in relation to others, in-line with the social changes prominent in individuals experiencing worsening symptoms of psychosis. 50,51,71 Increased use of first-person pronouns may also be indicative of emerging self-referential thinking, a common psychotic experience contributing to delusions, whereby neutral environmental stimuli are perceived to be personally meaningful. 37 In contrast to those at risk for developing psychotic disorders, we did not find that the use of determiners 60 or possessive pronouns 61 were associated with psychotic symptom exacerbation, which may represent linguistic differences among individuals who develop a psychotic disorder compared to those who relapse, or more likely, differences in the way individuals communicate through speech versus Facebook.…”

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

“…Existing early signs studies have typically used pen and paper questionnaires (Birchwood et al, 1989; Gaebel et al, 1993; Gaebel and Riesbeck, 2007, Gaebel and Riesbeck, 2014; Gleeson et al, 2005; Gumley et al, 2015; Hirsch and Jolley, 1989; Jørgensen, 1998; Malla and Norman, 1994; Marder et al, 1991; Marder et al, 1994; Subotnik and Neuchterlein, 1988; Tait et al, 2002; Tarrier et al, 1991) or text message systems (Spaniel et al, 2018; Spaniel et al, 2007; Spaniel et al, 2008) to examine the predictive value of conventional early signs of relapse. Compared to these methods, smartphone apps have a number of advantages: apps can be accessed at the individual's convenience (Ben-Zeev et al, 2013), decreasing participant burden and increasing ecological validity (Bucci et al, 2018); apps can automatically supply surveys and securely upload responses; finally, apps are more acceptable to individuals with psychosis than text message systems (Ainsworth et al, 2013).…”

Adverse event monitoring in mHealth for psychosis interventions provides an important opportunity for learning

“…None of those studies described having undertaken adverse events monitoring. We identified nine further studies of mHealth for psychosis that either did not meet the inclusion criteria for the Bell et al (2017) review or which were published subsequent to the review (Ainsworth et al, 2013;Barnett et al, 2018;Bucci et al, 2018;Eisner et al, in press;Kumar et al, 2018;Meyer et al, 2018;Palmier-Claus et al, 2012;Španiel et al, 2018) Of these just one described adverse event monitoring and in that instance it was limited to the identification of serious adverse events 1 , with none noted over the twelve-month period of the Actissist trial (Bucci et al, 2018). There was no indication of whether non-serious events were monitored or whether the relatedness of events to the digital intervention was assessed.…”