Digital Therapeutics for People with Schizophrenia Spectrum Disorders: A Systematic Literature Review of Their Effect on Symptoms and Functioning

Abstract

Background and Hypothesis Digital therapeutics (DTs; health software to treat/alleviate a disease/condition) may provide accessible evidence-based care to people with schizophrenia spectrum disorders (SSDs). This systematic literature review (SLR) investigated whether people with SSD find DTs acceptable and can use them effectively; whether DTs are effective and generally safe; and if DT use can impact functioning, quality of life (QoL), and other outcomes. Study Design This PROSPERO-registered SLR (CRD42023476545) was conducted to identify articles assessing DTs in adults with SSD. Databases (MEDLINE/Embase/PsycINFO/Cochrane-SR/ClinicalTrials.gov/WHO International Clinical Trials Registry) and key congresses were searched up to January 28, 2024. Screening was completed by 2 reviewers, each blinded to the other’s decisions, and article summaries were extracted. Study Results Of 886 unique citations, 115 eligible citations provided 38 unique primary studies with results and 10 linked citations. Engagement and satisfaction with DTs were generally high. Among 24 studies assessing the effectiveness of DT use on negative and positive symptoms, cognitive performance, mood, depression and/or anxiety, medication adherence, recovery, and general/other symptoms, 17 had ≥1 outcome showing significant change versus comparator/baseline; 24 had ≥1 outcome showing no significant difference. DTs were generally safe. Of 24 studies reporting real-world functioning, QoL, and other outcomes, 11 reported ≥1 significant outcome; 24 reported ≥1 outcome showing no difference versus comparator/baseline. Conclusions People with SSD can use DTs effectively and find them acceptable. Although effectiveness outcomes varied across/within studies, DTs may provide an acceptable strategy for delivering accessible, generally safe, evidence-based care to people with SSD.