Challenging Perceived Barriers to Digital Therapeutic Treatment Among Patients with Experiential Negative Symptoms of Schizophrenia

Introduction Experiential negative symptoms (ENS) are a major schizophrenia associated burden. Perceptions about the inability of people with schizophrenia to use technology are a barrier for adoption of accessible digital treatments. This study tests two perceptions: that people with schizophrenia are not digitally literate, or able to use digital treatments. Methods Participants with moderate ENS had access to a beta version of a prescription digital therapeutic(PDT) designed to target ENS for a 3-week, single-arm study. At baseline, negative symptoms(Clinical Assessment Interview for Negative Symptoms Motivation and Pleasure Scale [CAINS-MAP]) and digital literacy (Mobile Device Proficiency Questionnaire [MDPQ]) were assessed. PDT engagement was measured throughout the study. Results Participants (Nf49) were majority male (71.4%) with a median age of 46 years. At baseline, the median (range) CAINS MAP score was 2.44 (0.3 - 3.8), encompassing moderate to severe symptom severity. Median MDPQ score of 32.01 at baseline indicating high digital literacy, including high levels of proficiency in mobile device basics (Mdn 4.61). Participants completed a median of 17 lessons out of 18 available core lessons. Discussion Baseline demographics and CAINS-MAP scores show we enrolled a representative sample of people with schizophrenia, which includes both participants who were older and experiencing high levels of ENS. Despite the perceived inability of this population to engage with digital technologies, participants in this study reported high proficiency with mobile devices and demonstrated robust PDT engagement. Results suggest that PDTs are a feasible and encouraging approach to evidence-based care.