Bettina van Wylich-Muxoll

Smartphones as data-collection tools for mental health

Smartphones can be used as data-collection tools for mental health. In fact, this blog post is a summary of a research paper titled “Mobile phones as medical devices in mental disorder treatment.” To download the research paper, visit our Resource Library.

One in four Europeans have suffered from at least one mental disorder during their lifetime [2]. In the USA 26.2% of the population, 60 million people, suffer from at least one form of mental disorder [3]. Mental disorders can have a significant, negative impact on sufferers’ lives, as well as on their friends and family. More than 90% of people who commit suicide have a diagnosable mental disorder [4].

Currently, the monitoring of mental disorders relies mainly on self-reporting, developed more than 50 years ago. Hence, the researchers reviewed different systems that utilise mobile phones  as data-collection tools for mental health. They evaluated how their core design features and dimensions can be applied in other systems and they looked into the feasibility of using mobile phones to collect data including voice data, motion and location information.


Smartphones as data-collection tools for mental health 

From a technology point of view, mobile phones offer a promising hardware platform for various applications. In developed countries almost everybody owns a mobile phone; world-wide this adds up to 4.5 billion users [5].

Smartphones are accounted for 51.8% of mobile phone sales in 2013 worldwide [6]. As of 2014, one third of the currently world-wide used mobile phones are already smartphones [5]. Their cost has dropped dramatically and functionality continues to expand.


Smartphones are also a powerful technical platform. They are powerful in terms of CPU, memory, and battery. They also have extensive communication capabilities with their built-in network interfaces for 3G/4G, Wi-Fi, and Bluetooth; and they are equipped with sensors including accelerometers, GPS, microphone, proximity sensors, etc.


A smartphone is personal and is almost always with a person [7]. This is especially useful when collecting automated data, since the smartphone acts as a wearable device located in the user’s pocket.


Moreover, studies have shown that the quality of the data collected through smartphone-based questionnaires is much higher in comparison to paper-based self-assessments [8]. Paper-based self-assessment requires that patients remember to carry them with them and fill them out, resulting in poor adherence rates, retrospective completion, and memory errors [9].
In contrast, adherence and compliance rates are significantly improved when patients their smartphone since it is always available [8].

Using smartphones for mental health

Many mental disorders are treated through a combination of pharmacotherapy and psychological treatment, such as Cognitive Behavioural Therapy (CBT). The objective of the treatment is to reduce symptoms by ingesting medication and to help patients identify and change their behaviour in a healthy manner.

A smartphone-based solution can provide real-time feedback, it allows individuals to observe their behavioural and disease patterns, and it can also be used as a reminder for medication intake. Moreover, besides having the capability to being used as sensor devices and communication tools. Therefore, remote consultations become feasible; for example, clinicians can communicate with individuals and schedule teleconsultations if needed.

Further, studies have shown that patient adherence rates for smartphone interventions are high. McTavish et al. introduced a smartphone application to support patients with alcohol addiction. 16 weeks after downloading the app, more than 70% of the initial group were still actively using it [10]. Kuhn et al. surveyed perceived helpfulness and satisfaction of post-traumatic stress disorder patients who used a smartphone application as self-management tool for their mental disorder [11]. The results presented were promising but only preliminary.


A recent project called MONARCA focused on bipolar disorder patients and used smartphone sensors as well as additional wearable sensors [12]. The analysis of acceleration data collected with smartphones revealed a correlation between physical activity levels and psychiatric assessment of degree of depression [13].

References:

[1] F.Gravenhorst, A. Muaremi, J. Bardram, A. Grunerbl, O. Mayora, G. Wurzer, M. Frost, V. Osmani, B.Arnrich, P. Lukowicz, G. Troster. Mobile phones as medical devices in mental disorder treatment. 2015.

[2] J. Alonso, M. C. Angermeyer, S. Bernert, R. Bruffaerts,T. Brugha, H. Bryson, G. d. Girolamo, R. d. Graaf, K. Demyttenaere, I. Gasquet, et al. Prevalence of mental disorders in europe: results from the european study of the epidemiology of mental disorders (esemed) project. Acta Psychiatrica Scandinavica, 109(s420):21{27, 2004.

[3] R. C. Kessler, W. T. Chiu, O. Demler, and E. E. Walters. Prevalence, severity, and comorbidity of 12-month dsm-iv disorders in the national comorbidity survey replication. Archives of general psychiatry, 62(6):617{627, 2005.

[4] Y. Conwell and D. Brent. Suicide and aging i: patterns of psychiatric diagnosis. International psychogeriatrics, 7(02):149{164, 1995.

[5] Ericsson AB. Interim ericsson mobility report. February 2014. http://www.ericsson.com/ericsson-mobility-report/.

[6] Gartner. Market share analysis: Mobile phones, worldwide, 2q13, 2013.

[7] A. K. Dey, K. Wac, D. Ferreira, K. Tassini, J.-H. Hong, and J. Ramos. Getting closer: an empirical investigation of the proximity of user to their smart phones. In Proceedings of the ACM International Conference on Ubiquitous computing, UbiComp ’11, pages 163{172, New York, NY, USA, 2011. ACM.

[8] J. E. Bardram, M. Frost, K. Szanto, M. Faurholt-Jepsen, M. Vinberg, and L. V. Kessing. Designing mobile health technology for bipolar disorder: a eld trial of the monarca system. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, CHI ’13, pages 2627{2636, New York, NY, USA, 2013. ACM.

[9] A. A. Stone, S. Shiman, J. E. Schwartz, J. E. Broderick, and M. R. Huord. Patient non-compliance with paper diaries. BMJ, 324(7347):1193{1194, 5 2002.

[10] F. M. McTavish, M.-Y. Chih, D. Shah, and D. H. Gustafson. How patients recovering from alcoholism use a smartphone intervention. Journal of dual diagnosis, 8(4):294{304, 2012.

[11] E. Kuhn, C. Greene, J. Homan, T. Nguyen, L. Wald, J. Schmidt, K. M. Ramsey, and J. Ruzek. Preliminary evaluation of ptsd coach, a smartphone app for posttraumatic stress symptoms. Military medicine, 179(1):12{18, 2014.

[12] A. Puiatti, S. Mudda, S. Giordano, and O. Mayora. Smartphone-centred wearable sensors network for monitoring patients with bipolar disorder. In Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE, pages 3644{3647. IEEE, 2011.

[13] V. Osmani, A. Maxhuni, A. Grunerbl, P. Lukowicz, C. Haring, and O. Mayora. Monitoring activity of patients with bipolar disorder using smart phones. In ACM Proceedings of International Conference on Advances in Mobile Computing and Multimedia (MoMM2013), DOI:10.1145/2536853.2536882, Vienna, Austria, December 2013.