Wearables in Schizophrenia: Update on Current and Future Clinical Applications

Abstract

Schizophrenia affects 1% of the world population and is associated with a reduction in life expectancy of 20 years. The increasing prevalence of both consumer technology and clinical-grade wearable technology offers new metrics to guide clinical decision-making remotely and in real time. Herein, recent literature is reviewed to determine the potential utility of wearables in schizophrenia, including their utility in diagnosis, first-episode psychosis, and relapse prevention and their acceptability to patients. Several studies have further confirmed the validity of various devices in their ability to track sleep—an especially useful metric in schizophrenia, as sleep disturbances may be predictive of disease onset or the acute worsening of psychotic symptoms. Through machine learning, wearable-obtained heart rate and motor activity were used to differentiate between controls and patients with schizophrenia. Wearables can capture the autonomic dysregulation that has been detected when patients are actively experiencing paranoia, hallucinations, or delusions. Multiple platforms are currently being researched, such as Health Outcomes Through Positive Engagement and Self-Empowerment, Mobile Therapeutic Attention for Treatment-Resistant Schizophrenia, and Sleepsight, that may ultimately link patient data to clinicians. The future is bright for wearables in schizophrenia, as the recent literature exemplifies their potential to offer real-time insights to guide diagnosis and management.

Schizophrenia - Time to Commit to Policy Change

“…[122][123][124] Although the fundamental importance of relationships between healthcare professionals and patients within care models also means that technological approaches are unlikely to replace existing models entirely; 125 wearable technologies and passive monitoring also show promise in augmenting diagnosis and monitoring disease progression. 126,127 Platforms like Health Outcomes Through Positive Engagement and Self-Empowerment (HOPES), and Mobile Therapeutic Attention for Treatment Resistant Schizophrenia (m-RESIST) are exploring the role of wearable devices in schizophrenia management. 126 Current information mainly comes from small-scale studies showing feasibility from the last 5-years, 126 with approaches like sleep pattern monitoring and real-time autonomic dysregulation tracking.…”

“…126,127 Platforms like Health Outcomes Through Positive Engagement and Self-Empowerment (HOPES), and Mobile Therapeutic Attention for Treatment Resistant Schizophrenia (m-RESIST) are exploring the role of wearable devices in schizophrenia management. 126 Current information mainly comes from small-scale studies showing feasibility from the last 5-years, 126 with approaches like sleep pattern monitoring and real-time autonomic dysregulation tracking. [128][129][130] Continued work is needed to improve comparisons of findings against clinically relevant assessment tools and prioritise interventions that demonstrate improvements in outcomes important to patients, such as treatment adherence (the extent to which medication is actually taken as prescribed) and relapse prediction.…”

Adherence to wearables by people with severe mental illness in Switzerland: Time-use study

“…A key component of digital technologies for people with mental disorders will be wearables (Fedor et al, 2023, Fonseka & Woo, 2022, Johnston et al, 2024. These are technologies such as smartwatches, fitness trackers and other devices that people carry with them, which record information, store it and, under certain circumstances, pass it on to medical professionals (Moorthy et al, 2024).…”

Integrating smartwatches in community mental health services for severe mental illness for detecting relapse and informing future intervention: A case series

“…Smartwatches are devices with the ability to capture key indicators of health including a person's activity level, sleep, heart rate, and electrodermal activity (EDA) (Reeder & David, 2016). Such markers have been shown to be useful predictors of mental health; predictive of relapse (Fonseka & Woo, 2022), treatment efficacy (Winkler et al, 2014), and diagnostically useful in identifying circadian disruptions (Jones et al, 2005). For clinicians, smartwatches may be an appealing prospect for both monitoring and treating patients.…”