OBJECTIVES: Electronic health records (EHR) are emerging as a promising real-world data source for mental health research. The purpose of this study is to identify the current state of EHR use in schizophrenia research in the UK.

METHODS: Research articles reporting any use of EHR for schizophrenia research in the UK, published in PubMed between Jan 1, 2019, and December 31, 2023, were included. Publications were reviewed for their data source, linkages to other datasets, and the availability of relevant sociodemographic, clinical, and clinical event variables. Of the 49 articles screened, nine eligible studies were identified.

RESULTS: All eligible studies (n=9) used EHR data sourced from secondary mental health services, with the South London and Maudsley NHS Foundation Trust (SLAM) being the most common source (89%, 8/9); 33% (3/9) of studies linked with other national databases. All but one study reported using natural language processing (NLP) to extract structured data from clinician notes. No study reported the EHR including data based on specific schizophrenia symptom assessment tools. Among the studies, the following variables were reported as not being available in the EHR: symptom severity, type and timing of comorbid physical disorders, dosing of antipsychotic medication, type and timing of receiving cognitive behavioral therapy, and the presence of cardiovascular disease risk factors.

CONCLUSIONS: Increasing the number of integrated EHR studies which link secondary mental health service datasets to primary care and other national databases will enhance our ability to ensure more complete data for schizophrenia research. But more importantly, integrated EHR studies will support bridging the gap towards “precision psychiatry”, where schizophrenia care is individualized for each patient.