Accepted for/Published in: JMIR Mental Health
Date Submitted: Jul 16, 2025
Date Accepted: Oct 31, 2025
Using smartphone-tracked behavioural markers to recognize depression and anxiety symptoms: Digital phenotyping in the Netherlands Study of Depression and Anxiety
ABSTRACT
Background:
Depression and anxiety are prevalent but commonly missed and misdiagnosed, an important concern because many patients do not experience spontaneous recovery and duration of untreated illness is associated with worse outcomes.
Objective:
This study explores the potential of using smartphone-tracked behavioral markers to support diagnostics and improve recognition of these disorders.
Methods:
We used the dedicated Behapp digital phenotyping platform to passively track location and app usage in 217 individuals, comprising symptomatic (n=109; depression/anxiety diagnosis or symptoms) and asymptomatic individuals (n=108; no diagnosis/symptoms). After quantifying 46 behavioural markers (e.g., % time at home), we applied a machine learning approach to (1) determine which markers are relevant for depression/anxiety recognition and (2) develop and evaluate diagnostic prediction models for doing so.
Results:
Our analysis identifies the total number of GPS-based trajectories as a potential marker of depression/anxiety, where individuals with fewer trajectories are more likely symptomatic. Models using this feature in combination with demographics or in isolation outperformed demographics-only models (AUCMdn=0.60 vs 0.60 vs 0.51).
Conclusions:
Collectively, these findings indicate that smartphone-tracked behavioural markers have limited discriminant ability in our study but potential to support future depression/anxiety diagnostics.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.