Digital technology for addressing cognitive impairment in recent-onset psychosis: A perspective

Imogen Bell; Roos M C A Pot-Kolder; Stephen J Wood; Barnaby Nelson; Nicola Acevedo; Alexandra Stainton; Katie Nicol; James Kean; Shayden Bryce; Cali F Bartholomeusz; Amity Watson; Orli Schwartz; Rothanthi Daglas-Georgiou; Courtney C Walton; Donel Martin; Magenta Simmons; Isabel Zbukvic; Andrew Thompson; Jennifer Nicholas; Mario Alvarez-Jimenez; Kelly Allott

doi:10.1016/j.scog.2022.100247

Digital technology for addressing cognitive impairment in recent-onset psychosis: A perspective

Schizophr Res Cogn. 2022 Mar 10:28:100247. doi: 10.1016/j.scog.2022.100247. eCollection 2022 Jun.

Authors

Imogen Bell^{1

2}, Roos M C A Pot-Kolder^{1

2}, Stephen J Wood^{1

2

3}, Barnaby Nelson^{1

2}, Nicola Acevedo^{1

2

4}, Alexandra Stainton^{1

2}, Katie Nicol^{1

2}, James Kean^{1

2}, Shayden Bryce^{1

2}, Cali F Bartholomeusz^{1

2}, Amity Watson^{1

2}, Orli Schwartz^{1

2

5}, Rothanthi Daglas-Georgiou^{1

2}, Courtney C Walton^{1

2}, Donel Martin⁶, Magenta Simmons^{1

2}, Isabel Zbukvic^{1

2}, Andrew Thompson^{1

2}, Jennifer Nicholas^{1

2}, Mario Alvarez-Jimenez^{1

2}, Kelly Allott^{1

2}

Affiliations

¹ Orygen, 35 Poplar Rd, Parkville 3052, Melbourne, VIC, Australia.
² Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
³ School of Psychology, University of Birmingham, UK.
⁴ Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.
⁵ Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.
⁶ School of Psychiatry, University of New South Wales and Black Dog Institute, NSW, Australia.

Abstract

Cognitive impairments in psychosis negatively impact functional recovery and quality of life. Existing interventions for improving cognitive impairment in recent-onset psychosis show inconsistent treatment efficacy, small effects, suboptimal engagement and limited generalizability to daily life functioning. In this perspective we explore how digital technology has the potential to address these limitations in order to improve cognitive and functional outcomes in recent-onset psychosis. Computer programs can be used for standardized, automated delivery of cognitive remediation training. Virtual reality provides the opportunity for learning and practicing cognitive skills in real-world scenarios within a virtual environment. Smartphone apps could be used for notification reminders for everyday tasks to compensate for cognitive difficulties. Internet-based technologies can offer psychoeducation and training materials for enhancing cognitive skills. Early findings indicate some forms of digital interventions for cognitive enhancement can be effective, with well-established evidence for human-supported computer-based cognitive remediation in recent-onset psychosis. Emerging evidence regarding virtual reality is favorable for improving social cognition. Overall, blending digital interventions with human support improves engagement and effectiveness. Despite the potential of digital interventions for enhancing cognition in recent-onset psychosis, few studies have been conducted to date. Implementation challenges affecting application of digital technologies for cognitive impairment in recent-onset psychosis are sustained engagement, clinical integration, and lack of quality in the commercial marketplace. Future opportunities lie in including motivational frameworks and behavioral change interventions, increasing service engagement in young people and lived experience involvement in digital intervention development.

Keywords: Cognition; Digital therapy; Functional recovery; Psychosis; Treatment.

Grants and funding

WT_/Wellcome Trust/United Kingdom