Technology and Mental Health: State of the Art for Assessment and Treatment
Publication: American Journal of Psychiatry
Abstract
Technology is ubiquitous in society and is now being extensively used in mental health applications. Both assessment and treatment strategies are being developed and deployed at a rapid pace. The authors review the current domains of technology utilization, describe standards for quality evaluation, and forecast future developments. This review examines technology-based assessments of cognition, emotion, functional capacity and everyday functioning, virtual reality approaches to assessment and treatment, ecological momentary assessment, passive measurement strategies including geolocation, movement, and physiological parameters, and technology-based cognitive and functional skills training. There are many technology-based approaches that are evidence based and are supported through the results of systematic reviews and meta-analyses. Other strategies are less well supported by high-quality evidence at present, but there are evaluation standards that are well articulated at this time. There are some clear challenges in selection of applications for specific conditions, but in several areas, including cognitive training, randomized clinical trials are available to support these interventions. Some of these technology-based interventions have been approved by the U.S. Food and Drug administration, which has clear standards for which types of applications, and which claims about them, need to be reviewed by the agency and which are exempt.
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History
Received: 24 December 2021
Revision received: 14 March 2022
Revision received: 2 May 2022
Accepted: 17 May 2022
Published online: 6 October 2022
Published in print: December 01, 2022
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Competing Interests
Dr. Harvey has served as a consultant for or received travel reimbursements from Acadia, Alkermes, BioExcel, Boehringer Ingelheim, Karuna Pharma, Merck Pharma, Minerva Pharma, Roche Pharma, and Sunovion (DSP) Pharma; he receives royalties for the Brief Assessment of Cognition in Schizophrenia (owned by WCG Verasci, Inc., and contained in the MATRICS Consensus Cognitive Battery); he is chief scientific officer of i-Function, and serves as a scientific consultant for EMA Wellness; he owns stock options in Mindstrong and equity interest in i-Function and EMA Wellness; he is compensated as an editor-in-chief by Elsevier; and he serves on the board of Skyland Trail. Dr. Rizzo has served as a consultant for Penumbra and Cognitive Leap. Dr. Strauss has served as a consultant for Acadia, Boehringer Ingelheim, Lundbeck, Minerva Neuroscience, Otsuka, and Sunovion; he is a research adviser at Quantic Innovations; he receives royalties in relation to commercial use of the Brief Negative Symptom Scale (BNSS), which are donated to the Brain and Behavior Research Foundation, and he has conducted trainings for MedAvante-ProPhase in conjunction with use of the BNSS. Dr. Carpenter has research grant or clinical trials contracts with Affect Neuro, Janssen, NIH, Neuronetics, and Neurolief; she has served as a consultant for Affect Neuro, Janssen, Neuronetics, Neurolief, Nexstim, Otsuka, Sage Therapeutics, and Sunovion; has she has received in-kind support for research projects from Affect Neuro, Janssen, Neuronetics, and Neurolief, and equipment loan from Nexstim. Dr. Kalin is Editor-in-Chief of the American Journal of Psychiatry, and Drs. McDonald and Rodriguez are Deputy Editors; the Editors’ disclosures are reported in the April issue of the Journal. Dr. Krystal has served as a consultant for Aptinyx, Biogen Bionomics, Boehringer Ingelheim, Epiodyne, EpiVario, Janssen Research and Development, Jazz Pharmaceuticals, Otsuka America Pharmaceutical, Spring Care, and Sunovion Pharmaceuticals; he is listed as co-inventor on a patent licensed by Yale to Spring Health; he serves on the board of directors of Freedom Biosciences and on scientific advisory boards for Biohaven Pharmaceuticals, BioXcel Therapeutics (clinical advisory board), Cerevel Therapeutics, Delix Therapeutics, Eisai, EpiVario, Jazz Pharmaceuticals, Neumora Therapeutics, Neurocrine Biosciences, Novartis, PsychoGenics, Tempero Bio, and Terran Biosciences; he holds stock in Biohaven Pharmaceuticals and Spring Care and stock options in Biohaven Pharmaceuticals Medical Sciences, EpiVario, Neumora Therapeutics, Tempero Bio, and Terran Biosciences; he serves on the editorial board of Biological Psychiatry; he is named on U.S. patents 5,447,948, 8,778,979, and 9592207, patent application nos. 15/379,013, 61/973/961, 62/444,552, 62/719,935, and 63/125,181, and USPTO docket number Y0087.70116US00; and he has received study medications from AstraZeneca, Cerevel, and Novartis. Dr. Nemeroff has served as a consultant for AbbVie, Acadia Pharmaceuticals, Alfasigma, ANeuroTech (division of Anima BV), BioXcel Therapeutics, Corcept Therapeutics Pharmaceuticals Company, EcoR1, EMA Wellness, Engrail Therapeutics, GoodCap Pharmaceuticals, Intra-Cellular Therapies, Magstim, Navitor Pharmaceuticals, Neuritek, Pasithea Therapeutic Corp., Sage, Senseye, Signant Health, Silo Pharma, SK Life Science, and XW Pharma and on scientific advisory boards for ANeuroTech, the Anxiety and Depression Association of America (ADAA), the Brain and Behavior Research Foundation, Heading Health, the Laureate Institute for Brain Research, Magnolia CNS, Pasithea Therapeutics, Sage, Skyland Trail, Signant Health, and TRUUST Neuroimaging; he serves on boards of directors for ADAA, Gratitude America, Lucy Scientific Discovery, and Xhale Smart; he is a stockholder in Antares, BI Gen Holdings, Corcept Therapeutics Pharmaceuticals Company, EMA Wellness, Seattle Genetics, Naki Health, TRUUST Neuroimaging, and Xhale; and he holds patents on a method and devices for transdermal delivery of lithium (US 6,375,990B1) and on a method of assessing antidepressant drug therapy via transport inhibition of monoamine neurotransmitters by ex vivo assay (US 7,148,027B2). Dr. Widge has served as a consultant for Dandelion Science; he has received device donations from Medtronic; and he has unlicensed patents in the area of biomarkers and methods for tracking mental health symptoms. Dr. Torous has received support from Otsuka and is a cofounder of Precision Mental Wellness. The other authors report no financial relationships with commercial interests.
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