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Accepted for/Published in: JMIR Mental Health

Date Submitted: Jul 16, 2025
Date Accepted: Oct 31, 2025

The final, peer-reviewed published version of this preprint can be found here:

Using Smartphone-Tracked Behavioral Markers to Recognize Depression and Anxiety Symptoms: Cross-Sectional Digital Phenotyping Study

Aalbers G, Costanzo A, Jagesar R, Lamers F, Kas MJH, Penninx BWJH

Using Smartphone-Tracked Behavioral Markers to Recognize Depression and Anxiety Symptoms: Cross-Sectional Digital Phenotyping Study

JMIR Ment Health 2026;13:e80765

DOI: 10.2196/80765

PMID: 41589818

PMCID: 12836477

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Using smartphone-tracked behavioural markers to recognize depression and anxiety symptoms: Digital phenotyping in the Netherlands Study of Depression and Anxiety

  • George Aalbers; 
  • Andrea Costanzo; 
  • Raj Jagesar; 
  • Femke Lamers; 
  • Martien J. H. Kas; 
  • Brenda W. J. H. Penninx

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

Please cite as:

Aalbers G, Costanzo A, Jagesar R, Lamers F, Kas MJH, Penninx BWJH

Using Smartphone-Tracked Behavioral Markers to Recognize Depression and Anxiety Symptoms: Cross-Sectional Digital Phenotyping Study

JMIR Ment Health 2026;13:e80765

DOI: 10.2196/80765

PMID: 41589818

PMCID: 12836477

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