Elsevier

Journal of Affective Disorders

Volume 226, 15 January 2018, Pages 169-177
Journal of Affective Disorders

Review article
Novel technology as platform for interventions for caregivers and individuals with severe mental health illnesses: A systematic review

https://doi.org/10.1016/j.jad.2017.09.012Get rights and content

Highlights

  • Systematic review of web-based and smartphone-based interventions for SMIs.

  • All studies focused on the patients themselves but not on their informal caregivers.

  • Only a few evaluated programs were identified but they proved to be feasible and acceptable to users.

  • Efficacy of those programs has not been tested for most of them.

  • There is a huge untested potential for such interventions, espescially when considering caregivers.

Abstract

Background

Severe mental illnesses (SMIs) have been found to be associated with both increases in morbidity-mortality, need for treatment care in patients themselves, and burden for relatives as caregivers. A growing number of web-based and mobile software applications have appeared that aim to address various barriers with respect to access to care. Our objective was to review and summarize recent advancements in such interventions for caregivers of individuals with a SMI.

Methods

We conducted a systematic search for papers evaluating interactive mobile or web-based software (using no or only minimal support from a professional) specifically aimed at supporting informal caregivers. We also searched for those supporting patients with SMI so as to not to miss any which might include relatives.

Results

Out of a total of 1673 initial hits, we identified 11 articles reporting on 9 different mobile or web-based software programs. The main result is that none of those studies focused on caregivers, and the ones we identified using mobile or web-based applications were just for patients and not their relatives.

Limitations

Differentiating between online and offline available software might not always have been totally reliable, and we might have therefore missed some studies.

Conclusions

In summary, the studies provided evidence that remotely accessible interventions for patients with SMI are feasible and acceptable to patients. No such empirically evaluated program was available for informal caregivers such as relatives. Keeping in mind the influential role of those informal caregivers in the process of treatment and self-management, this is highly relevant for public health. Supporting informal caregivers can improve well-being of both caregivers and patients.

Section snippets

Background

Severe mental illness (SMI) is an umbrella term involving numerous psychiatric disorders, namely bipolar disorder (BD), schizophrenia, and major depressive disorder (MDD) (Schinnar et al., 1990). The National Institute of Mental Health's (NIMH) definition is used most frequently using three criteria: a) diagnosis of a mental, behavioral, or emotional disorder, b) duration, i.e. current or recent diagnosis in the past year, and c) disability, i.e. serious functional impairment (Cooper, 1988,

Methods

We searched Pubmed, Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, PsycInfo, and ACM DL, till July 2017. Studies on severe mental health disorders and mobile and/or web-based applications were included. We have used specific search terms namely- serious mental illn*, severe mental illn*, internet or World Wide Web, mobile applicatio* or web based applicatio* or android applicatio* or iOS applicatio* or windows applicatio* or macintosh applicatio* etc.

Our inclusion criteria

Results

The first and main finding was that as a result of examining the full texts of the 102 papers from the first sift based on the title and abstract, we did not identify a single paper which focused on caregivers with or without their respective patients. At this stage, we decided to review at least the evidence for apps and web-based interventions for individuals with a SMI regardless of inclusion of their loved ones (i.e. ignoring inclusion criterion 3). Furthermore, realizing that this form of

Discussion

The original goal was to review the advancements of Internet-based computer programs and mobile software applications developed for caregivers of patients with a SMI in order to increase access to treatment, to support their role as informal caretakers and to improve their well-being. Despite the important and growing role of significant others as informal caregivers (Grover et al., 2013, Gupta et al., 2015, Tan et al., 2012), not one single study was focused on the well-being of relatives as

Contributors

Thomas D. Meyer and M. Sriram Iyengar designed the protocol for the review paper search and supervised the searches and data extraction as well as the write-up of the paper. Satyajit S. Mohite conducted the searches and together with Nikki La Rosa did the data extraction. Rebecca Casarez contributed to the write-up of the final manuscript. All authors contributed and proofread the final version of the manuscript. All authors have approved the final article.

Role of funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest

None of the authors is aware of any conflict of interest with regards to this review.

Acknowledgment

We thank Dr. Isabelle Bauer and Nic Crist for proofreading the final version of the manuscript and helpful comments.

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