Leveraging Personal Technologies in the Treatment ofSchizophrenia Spectrum Disorders:Scoping Review

Background: Digital mental health is a rapidly growing field with an increasing evidence base due to its potential scalabilityand impacts on access to mental health care. Further, within underfunded service systems, leveraging personal technologies todeliver or support specialized service delivery has garnered attention as a feasible and cost-effective means of improving access.Digital health relevance has also improved as technology ownership in individuals with schizophrenia has improved and iscomparable to that of the general population. However, less digital health research has been conducted in groups with schizophreniaspectrum disorders compared to other mental health conditions, and overall feasibility, efficacy, and clinical integration remainlargely unknown. Objective: This review aims to describe the available literature investigating the use of personal technologies (ie, phone,computer, tablet, and wearables) to deliver or support specialized care for schizophrenia and examine opportunities and barriersto integrating this technology into care. Methods: Given the size of this review, we used scoping review methods. We searched 3 major databases with search teamsrelated to schizophrenia spectrum disorders, various personal technologies, and intervention outcomes related to recovery. Weincluded studies from the full spectrum of methodologies, from development papers to implementation trials. Methods andreporting follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: This search resulted in 999 studies, which, through review by at least 2 reviewers, included 92 publications. Includedstudies were published from 2010 to 2023. Most studies examined multitechnology interventions (40/92, 43%) or smartphoneapps (25/92, 27%), followed by SMS text messaging (16/92, 17%) and internet-based interventions (11/92, 12%). No studiesused wearable technology on its own to deliver an intervention. Regarding the stage of research in the field, the largest numberof publications were pilot studies (32/92, 35%), followed by randomized control trials (RCTs; 20/92, 22%), secondary analyses(16/92, 17%), RCT protocols (16/92, 17%), development papers (5/92, 5%), and nonrandomized or quasi-experimental trials(3/92, 3%). Most studies did not report on safety indices (55/92, 60%) or privacy precautions (64/92, 70%). Included studies tendto report consistent positive user feedback regarding the usability, acceptability, and satisfaction with technology; however,engagement metrics are highly variable and report mixed outcomes. Furthermore, efficacy at both the pilot and RCT levels reportmixed findings on primary outcomes. Conclusions: Overall, the findings of this review highlight the discrepancy between the high levels of acceptability and usabilityof these digital interventions, mixed efficacy results, and difficulties with sustained engagement. The discussion highlightscommon patterns that may underscore this observation in the field; however, as this was a scoping review, a more in-depthsystematic review or meta-analysis may be required to better understand the trends outlined in this review