Digital technology may support sustained long-term recovery in first episode psychosis

Evolving technology can offer people with first episode psychosis personalized treatment when they need it, where they need it and for as long as they need it. The APA’s 2021 Annual Meeting heard evidence that using social media to build therapeutic networks can improve long-term functional outcomes.

Digital mobile technology may be able to extend the benefits of early intervention in first episode psychosis (FEP) and enhance the prospects of sustained recovery.1 Though these are early days in a rapidly evolving field, initial results presented at APAAM21 by Mario Alvarez-Jimenez (Orygen, Parkville, Victoria, Australia) suggest promise.2

Preliminary data from a trial in which 170 patients with FEP in remission were randomized to treatment as usual or the innovative Horyzons social media program show that people assigned to the latter were significantly more likely to be in employment at 18 months and were less likely to have been admitted to hospital for psychosis or accessed the emergency services.

We can build a social network to promote wellbeing rather than simply to promote clicks and sell advertising

Interestingly, the beneficial effect of the platform on vocational outcome was concentrated among participants who had most log-ins to both its therapeutic and social elements. Efforts to promote such sustained usage are now a key aspect of further development, Dr Alvarez-Jimenez said.

 

Accessible, affordable, engaging, effective….

Features of the Horyzons platform designed to build on and sustain the clinical gains achieved by existing integrated early interventions include1

  • peer-to-peer social networking
  • moderation of the platform both by experts and by peers
  • a range of therapies, such as mindfulness and those targeted at enhanced social functioning, and
  • a personalized program that emphasizes what works for individual patients, known as “therapeutic gems”.

Digital interventions are well placed to address the lack of social connection accompanying first episode psychosis5

Success so far shows that it is possible to build an ethical social network to promote wellbeing and encourage social relationships, rather than simply to promote clicks and sell advertising.

Traditional face-to-face therapeutic encounters are frequently difficult to access on a sustained basis, may not attract full patient engagement, and do not always benefit outcomes such as social functioning, Mario Alvarez-Jimenez noted.

 

Expanding Horyzons

Mobile digital technologies, in contrast, are accessible everywhere and are continuously available. Moreover, they are found compelling by young people and have become an intrinsic element in their social activity.

Young people with psychosis and depression are as likely as their peers to use social media, and more than seventy percent say they would welcome professional support through social media and digital technology.3,4

The most valued outcome for patients with first episode psychosis is sustained recovery in social and working life

The most valued outcome for patients with first episode psychosis is sustained recovery in social and working life. Technological innovations may become an important means of achieving it.

Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

References

1. Alvarez-Jimenez M et al. HORYZONS trial: protocol for a randomised controlled trial of a moderated online social therapy to maintain treatment effects from first-episode psychosis services.  BMJ Open 2019; 9:2

2. Alvarez-Jimenez M et al. World Psychiatry, in press

3. Highton-Williamson E et al.  Online social networking in people with psychosis: A systematic review.

Int J Soc Psychiatry 2015; 61:92-101

4.  Birnbaum ML et al. Role of social media and the Internet in pathways to care for adolescents and young adults with psychotic disorders and non-psychotic mood disorders. Early Interv Psychiatry 2017;11:290-295

5.  Valentine L et al. Young People's Experience of a Long-Term Social Media-Based Intervention for First-Episode Psychosis: Qualitative Analysis. Med Internet Res 2020 ;22:e17570. doi: 10.2196/17570

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