Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 24, 2020
Date Accepted: Jul 19, 2021
Evaluation of changes in depression, anxiety, and social anxiety using smartphone sensor features: Longitudinal cohort study
ABSTRACT
Background:
Assessment of behaviors related to mental health has typically relied on self-report data. Networked sensors embedded in smartphones can measure some behaviors objectively, continuously, with no ongoing effort.
Objective:
We aimed to evaluate whether changes in phone sensor-derived behavioral features were associated with subsequent changes in mental health symptoms.
Methods:
This longitudinal cohort study examined continuously collected phone sensor data and symptom severity data, collected every 3 weeks, over 16 weeks. Participants were recruited through national research registries. Primary outcomes included: depression (PHQ-8), generalized anxiety (GAD-7), and social anxiety (SPIN) severity. Participants were adults who owned Android smartphones. Participants clustered into 4 groups: Multiple comorbidities, depression and generalized anxiety, depression and social anxiety, and minimal symptoms.
Results:
282 participants were aged 19 - 69 (M=38.9, SD=11.9), primarily female (74.8%), and white (80.1%). Among the multiple comorbidities group, depression changes were preceded by changes in all GPS features (Transitions: r=-0.18, P=.02; Time: r=-0.23, P=.004; Locations: r=-0.35, P<.001), exercise duration (r=0.22, P=.01), and use of active apps (r=-0.30, P<.001). Among the depression and anxiety group, change in depression was preceded by change in GPS features for locations and transitions (Locations: r=-0.16, P=.02; Transitions: r=-0.20, P=.006). Among the depression and social anxiety group, change in depression was preceded by change in GPS features for locations and time in locations, (Locations: r=-0.18,P=.02; Time: r=-0.17, P=.02), and time in social activities (r=-0.19, P=.02). Depression changes were not related to subsequent sensor-derived features. The minimal symptoms group had no significant relationships. There were minimal associations between sensor-based features and anxiety or social anxiety.
Conclusions:
Changes in sensor-derived behavioral features are associated with subsequent depression changes, but not vice versa, suggesting a directional relationship in which sensed behaviors are early indicators of symptom changes.
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