JMIR Publications

ABSTRACT

Background:

Improving mental health in youth is an issue of major concern. Future approaches to trace and intervene on youth mental health should rely on mobile approaches allowing to monitor mental health daily both actively (e.g., using Ecological Momentary Assessments- EMAs) and passively (e.g., digital phenotyping) by capturing individuals’ data.

Objective:

This umbrella review aims to (1) report the main characteristics of the existing reviews on mental health and young people including mobile approaches to mental health, (2) describe EMA and trace data, and the mental health conditions investigated, (3) report the main results, and, finally, (4) outline promises, limitations, and directions for future research.

Methods:

A systematic literature search was carried out in nine scientific databases, coupled with a hand search, in 2022. The protocol of the review was registered in PROSPERO database. The quality of included reviews was evaluated using the “Assessment of Multiple Systematic Reviews” (AMSTAR) checklist.

Results:

After the screening process, 30 reviews (published between 2016 and 2022) were included in the present umbrella review, of which 21 were systematic and 9 narrative reviews. Included reviews focused on symptoms of depression (n=5), bipolar disorders with and without schizophrenia or psychosis (n=6), general illbeing (n=5), cognitive abilities (n=2), well-being (n=1), personality (n=1), and suicidal thoughts (n=1). Among systematic reviews, fifteen reviews summarized studies using mobile applications for tracing, two for intervention, and four both intervention and tracing. Mobile tools used in systematic reviews were smartphones only (n=8), smartphones and wearable devices (n=6), and smartphones with other tools (n=7). Six systematic reviews focused on EMAs (including EMIs), seven on trace data, and eight on both. Narrative reviews mainly focused on the discussion of: issues related to digital phenotyping, existing used theoretical frameworks, new opportunities, and practical examples.

Conclusions:

In general, EMA and trace data in the context of mental health assessment and intervention are promising tools. Opportunities include the possibility to use mobile approaches in low- and middle-income countries, the integration of multimodal data, including inferring individual neurobiology from digital footprints, and the possibility to improve self-efficacy and self-awareness, using also a positive psychology framework. However, limitations rely in the absence of theoretical frameworks, difficulty in assessing reliability and effectiveness of such approaches with respect to gold standards, their appropriateness at large scale in public health, the difficulty in data analysis, and the need to appropriately assess the quality of the studies. Clinical Trial: The protocol is registered in PROSPERO (CRD42022347717).