JMIR Publications

ABSTRACT

Background:

There is considerable scientific interest in finding new and innovative ways to capture rapid fluctuations in functioning within individuals with bipolar disorder (BD), severe, recurrent mental disorder associated with frequent shifts in symptoms and functioning. The use of smartphones can provide valid and “real-world” tools for use in measurement-based care and could be used to inform more personalized treatment options for this group which can improve standard of care.

Objective:

We examined the feasibility and usability of a smartphone to capture daily fluctuations in mood within bipolar disorder (BD) and to relate daily self-rated mood to smartphone-use behaviors indicative of psychomotor activity or symptoms of the illness.

Methods:

Participants were 26 individuals with BD and 12 healthy control (HC) who recruited from the Prechter Longitudinal Study of BD. All were given a smartphone with a custom-built application and prompted twice a day to complete assessments of mood for 28 days. The application continuously and unobtrusively collected phone sensor data. A post-study satisfaction survey was also completed.

Results:

Our sample showed a very high adherence rate to the daily momentary assessments (91% of the 58 prompts completed). Multivariate mixed effect models showed that an increase in rapid thoughts over time was associated with a decrease in outgoing text messages (β=-0.02, P=.04) and an increase in impulsivity self-ratings was related to a decrease in total call duration (β=-0.29, P=.02). Participants generally reported positive experiences using the smartphone and with completing daily prompts.

Conclusions:

Use of mobile technology shows promise as a way to collect important clinical information that can be used to inform treatment decision-making and monitor outcomes in a manner that is not overly burdensome to the patient or providers and highlights its potential use in measurement-based care.