Department of Psychiatry, University of Hong Kong, Hong Kong.
State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.
Early Interv Psychiatry. 2021 Dec;15(6):1659-1666. doi: 10.1111/eip.13108. Epub 2020 Dec 23.
Psychotic disorders are associated with a high rate of relapse. In addition to medication non-adherence, some psychosocial factors have been found to be predictive of relapse (e.g., poor premorbid adjustment, high expressed emotion and substance misuse). Impairments in cognitive functions including general memory functioning, set shifting, attention, processing speed and working memory have also been indicative of a subsequent psychotic episode. As clinical appointments do not always allow for timely or accurate detection of these early warning signs, the ReMind app is developed to explore potential relapse predictors and enhance the process of relapse monitoring.
The ReMind app aims (1) to assess whether verbal or visual working memory predicts psychotic relapse in 1 year and (2) to determine whether social factors such as stressful life events, level of expressed emotion and medication adherence also predict relapse in 1 year.
This is a one-year prospective follow-up study involving 176 remitted patients diagnosed with schizophrenia or non-affective psychoses. Monthly relapse predictor assessments will be conducted via ReMind throughout the one-year study duration. These assessments include neurocognitive tasks and psychosocial questionnaires.
Recruitment began in August 2017 and is still ongoing. Preliminary user feedback suggested an overall positive experience with the app.
The ReMind app presents a step forward to the identification and sensitive detection of reliable psychosis relapse predictors. With its anticipated success, it may offer an alternative means of monitoring relapse for the Chinese-speaking population in the future.
精神障碍与高复发率相关。除了药物依从性差之外，一些心理社会因素也被发现与复发有关（例如，病前调整不良、高表达情感和物质滥用）。认知功能的损害，包括一般记忆功能、定势转移、注意力、处理速度和工作记忆，也预示着随后会出现精神病发作。由于临床预约并不总是允许及时或准确地发现这些早期预警信号，因此开发了 ReMind 应用程序来探索潜在的复发预测指标，并增强复发监测过程。
ReMind 应用程序旨在（1）评估言语或视觉工作记忆是否能预测 1 年内的精神病复发，以及（2）确定社会因素（如生活压力事件、表达情感水平和药物依从性）是否也能预测 1 年内的复发。
这是一项为期 1 年的前瞻性随访研究，涉及 176 名缓解期诊断为精神分裂症或非情感性精神病的患者。在为期 1 年的研究期间，将通过 ReMind 每月进行一次复发预测评估。这些评估包括神经认知任务和心理社会问卷。
招募工作于 2017 年 8 月开始，目前仍在进行中。初步用户反馈表明，该应用程序总体体验良好。
ReMind 应用程序在识别和敏感检测可靠的精神病复发预测指标方面向前迈进了一步。如果取得预期成功，它可能为未来讲中文的人群提供一种替代的监测复发的方法。
