Smartphone digital phenotyping, surveys, and cognitive assessments for global mental health: Initial data and clinical correlations from an international first episode psychosis study

Tanvi Lakhtakia, Ameya Bondre, Prabhat Kumar Chand, Nirmal Chaturvedi, Soumya Choudhary, Danielle Currey, Siddharth Dutt, Azaz Khan, Mohit Kumar, Snehil Gupta, Srilakshmi Nagendra, Preethi V Reddy, Abhijit Rozatkar, Luke Scheuer, Yogendra Sen, Ritu Shrivastava, Rahul Singh, Jagadisha Thirthalli, Deepak Kumar Tugnawat, Anant Bhan, John A Naslund, Vikram Patel, Matcheri Keshavan, Urvakhsh Meherwan Mehta, John Torous, Tanvi Lakhtakia, Ameya Bondre, Prabhat Kumar Chand, Nirmal Chaturvedi, Soumya Choudhary, Danielle Currey, Siddharth Dutt, Azaz Khan, Mohit Kumar, Snehil Gupta, Srilakshmi Nagendra, Preethi V Reddy, Abhijit Rozatkar, Luke Scheuer, Yogendra Sen, Ritu Shrivastava, Rahul Singh, Jagadisha Thirthalli, Deepak Kumar Tugnawat, Anant Bhan, John A Naslund, Vikram Patel, Matcheri Keshavan, Urvakhsh Meherwan Mehta, John Torous

Abstract

Objective: To examine feasibility and acceptability of smartphone mental health app use for symptom, cognitive, and digital phenotyping monitoring among people with schizophrenia in India and the United States.

Methods: Participants in Boston, USA and Bhopal and Bangalore, India used a smartphone app to monitor symptoms, play cognitive games, access relaxation and psychoeducation resources and for one month, with an initial clinical and cognitive assessment and a one-month follow-up clinical assessment. Engagement with the app was compared between study sites, by clinical symptom severity and by cognitive functioning. Digital phenotyping data collection was also compared between three sites.

Results: By Kruskal-Wallis rank-sum test, we found no difference between app activities completed or digital phenotyping data collected across the three study sites. App use also did not correlate to clinical or cognitive assessment scores. When using the app for symptom monitoring, preliminary findings suggest app-based assessment correlate with standard cognitive and clinical assessments.

Conclusions: Smartphone app for symptom monitoring and digital phenotyping for individuals with schizophrenia appears feasible and acceptable in a global context. Clinical utility of this app for real-time assessments is promising, but further research is necessary to determine the long-term efficacy and generalizability for serious mental illness.

Keywords: Schizophrenia; digital health; global health; mental health; smartphone apps.

© The Author(s) 2022.

Figures

Figure 1.
Figure 1.
Mean games and surveys were completed per day by participants at each site. Participants received notifications to complete surveys twice per day and to complete games once per day.
Figure 2.
Figure 2.
Mean activities completed per day by BACS composite scaled score, symbol coding score, and token motor score.
Figure 3.
Figure 3.
Mean activities completed per day by total PANSS score.
Figure 4.
Figure 4.
Boxplots showing the quality of GPS data collected at each study site.
Figure 5.
Figure 5.
Mean EMA scores over 30 days versus average clinical assessment scores, between baseline and follow-up, for each study site and in total, by anxiety, mood, and psychosis symptom domains. Mean scores captured via EMA.
Figure 6.
Figure 6.
Average tap time for (a) jewels A and (b) jewels b (in seconds) for each study site, as varied by BACS composite scaled score, symbol coding score, and token motor score.
Appendix 5.
Appendix 5.
Relaxation and psychoeducation tips completed over one month by participants at each site. Participants received 2 relaxation notifications per week and periodic notifications about tips based on reported symptoms.
Appendix 7.
Appendix 7.
Mean entropy (representing variation in location in a day) of participants by study site, derived from location-based passive data.
Appendix 8.
Appendix 8.
Time spent at home in hours for participants by study site, derived from location-based passive data.

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Source: PubMed

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