The novel mobile application App4Independence may be a feasible solution to improve self-management in patients with schizophrenia spectrum disorders, according to study results published in PLOS ONE.

The researchers evaluated the feasibility of the app in 38 patients with a primary psychosis at a large urban center in Canada. Mean patient age was 31.4 years; 63% had a primary diagnosis of schizophrenia, and 71% identified as male. Pre- and post-assessments included psychiatric symptoms, medication compliance, and personal recovery over a 1-month period. Application metrics were analyzed using qualitative feedback obtained from semi-structured interviews with those in the study. The results were reported in accordance with the World Health Organization mHealth Evidence and Assessment checklist.

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After analysis, the researchers observed significant improvements in depression (Cohen’s d, 0.42; P =.001), obsessive compulsive (d, 0.38; P =.01), paranoid ideation (d, 0.29; P =.009), phobic anxiety (d, 0.23; P =.02), psychoticism (d, 0.22; P =.04), and interpersonal sensitivity (d, 0.18; P =.04). In patients, classic retention on the application platform was 52.5% and no research attrition was reported.

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Study limitations included a lack of a control condition and a small sample size.

“Satisfaction with the app was high and qualitative feedback provided insights regarding feature enhancements,” the researchers wrote.

“[App4Independence] is a technology that is ready to move on to clinical trial and validation testing,” they concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Kidd SA, Feldcamp L, Adler A, et al. Feasibility and outcomes of a multi-function mobile health approach for the schizophrenia spectrum: App4Independence (A4i). PLoS One. 2019;14(7):e0219491.