An ecological momentary intervention to improve social functioning in schizophrenia spectrum disorders- a friend in your pocket?

Anne-Kathrin Fett, PhD

Social functioning and psychosis4

68

1012

1416

Childhood

Early adolescence

Late adolescence

Class1

Class2

Class3

Class4

Controls

PAS

46

810

1214

16

0 2 4 6 8 10 12 14 16 18 20

Time after onset (years)

QLS

0 10 20 30 40 50

pMDD

pBD

SZ

0 10 20 30 40 50

pMDD

pBD

SZ

0 10 20 30 40 50

pMDD

pBD

SZ

0 10 20 30 40 50

pMDD

pBD

SZ

Velthorst, Fett et al. (2016), Am J Psych

ControlsAIMS

Can an interactive app with personalized tailored prompts increase social contact?

Method

• Outpatients with a diagnosis of SZ

• Two groups• personalised

feedback (n = 27)• without feedback

(n = 23) - € 150

Disentangle monitoring from interactive feedback effects

Good morning…

How was your day?

I feel Lonely

Suggestion for contact with friends or family

Medication reminder

Personalisedcoping tips and activities

What participants saidGood initiative, I was very happy with the app and

hope that it will be further developed. I think that

people with psychosis really can benefit from it…

I realised how alone I wasIt was

“gezellig” –I felt less

lonely

A bit irritating, samey…

Always nice to get a

beep

Gave me structure

Gave me ideas about what I

could do

More attention to how I was feeling

put things into perspective

I would like more feedback and link to

calendar function

Interfered with my structure

I would like to see my responses

ResultsNo change• Questionnaire measures social

engagement• ESM social engagement• ESM positive/negative affect

Decrease• Both groups: ESM loneliness• Feedback group: ESM positive • Both groups: Cape positive

• 64 enrolled, 9 non-completers• 6 < 30% of ESM

• No smartphone 14%

• Easy to use 94%

• Design appealing 95%

• Reflects my experiences 68%

• I used coping tips 74%

• App annoyed me at some point• Feedback 73% vs. No feedback 38%

Discussion – a friend in your pocket?• Overall feasible

• Not for everyone• Embedded in treatment

• Pilot study: interactive vs. non-interactive app• No funding for waitlist control• Loneliness: Spending time with app? “Asks me how I am doing…”• Digital placebo or interaction with researchers?

• Feedback is annoying and does not help• Maybe too much/not enough (relevant) feedback? • Make it optional

• Social interaction – opportunities?• Future: connect people, long term use, video feedback and

mobile sensing

Thank you for your attention!

The team• Esther Hanssen• Sanne Balvert• Jim van Os• Phillipe Delespaul• Karel Borkelmans• Cristi-Janne van As• Marlie Eemers• Suzanne Robberegt• Niels den Daas• Natalie Castien• Margreet Oorschot

Sample characteristics