Design and feasibility of smartphone-based digital phenotyping for long-term mental health monitoring in adolescents.

Abstract

Assessment of psychiatric symptoms relies on subjective self-report, which can be unreliable. Digital phenotyping collects data from smartphones to provide near-continuous behavioral monitoring. It can be used to provide objective information about an individual's mental state to improve clinical decision-making for both diagnosis and prognostication. The goal of this study was to evaluate the feasibility and acceptability of smartphone-based digital phenotyping for long-term mental health monitoring in adolescents with bipolar disorder and typically developing peers. Participants (aged 14-19) with bipolar disorder (BD) or with no mental health diagnoses were recruited for an 18-month observational study. Participants installed the Beiwe digital phenotyping app on their phones to collect passive data from their smartphone sensors and thrice-weekly surveys. Participants and caregivers were interviewed monthly to assess changes in the participant's mental health. Analyses focused on 48 participants who had completed participation. Average age at baseline was 15.85 years old (SD = 1.37). Approximately half (54%) identified as female, and 54% identified with a minoritized racial/ethnic background. Completion rates across data types were high, with 99% (826/835) of clinical interviews completed, 89% of passive data collected (22,233/25,029), and 47% (4,945/10,448) of thrice-weekly surveys submitted. The proportion of days passive data were collected was consistent over time for both groups; the clinical interview and active survey completion decreased over the study course. Results of this study suggest digital phenotyping has significant potential as a method of long-term mental health monitoring in adolescents. In contrast to traditional methods, including interview and self-report, it is lower burden and provides more complete data over time. A necessary next step is to determine how well the digital data capture changes in mental health to determine the clinical utility of this approach.