Do Mobile Applications Have a Place in Managing Bipolar Disorder?
Great potential exists for using objective smartphone data to discriminate between depressive and manic states in patients with bipolar disorder.
The use of mobile applications (apps) to improve the management of patients with chronic psychiatric illnesses like bipolar disorder (BD) is growing. One review found that approximately 570 BD-related mobile apps were available for download.1 Some provided information on BD, whereas others were aids for diagnosing and screening, managing symptoms, or finding community support.
Jennifer Nichols, a PhD candidate from Black Dog Institute at the University of New South Wales in Sydney, Australia, and lead author of the review, said mobile apps are useful because they “have the ability to place access to resources and support at a consumer's fingertips.” Nichols noted that “transforming a commonly used therapeutic tool such as a mood chart to a smartphone app has the potential to increase the usefulness and accuracy of consumer-reported mood, shifting from a reliance on recollection to real-time in vivo recording.” She said mobile apps also have the potential to “reinforce skills and provide support and information” when BD patients need it most, wherever they are.
A pilot study evaluated the effectiveness of a mobile app called SIMBA (Social Information Monitoring for Patients With Bipolar Affective Disorder) at using smartphone-collected data on physical and social activity plus auto-generated mood questionnaires to assess changes in clinical symptoms.2 The study included 13 German adults with BD I or II who agreed to use a smartphone equipped with the SIMBA app for approximately 1 year. The app used built-in sensors to measure distance traveled, location changes, and spatial movement. It also collected data on incoming or outgoing calls and text messages sent. Twice a day, the app randomly invited participants to take a mood assessment questionnaire. Participants also received in-person clinical assessments of manic and depressive symptoms every 8 weeks.
The study showed the app's questionnaire accurately predicted levels of clinical depressive symptoms.2 Declines in social and physical activity measured by the app corresponded with an increase in clinical depressive symptoms. A lower level of physical activity plus an increase in social activity corresponded with higher levels of clinical manic symptoms. A decrease in physical activity also predicted an increase in clinical manic symptoms, which was inconsistent with studies that have associated manic symptoms with an increase in psychomotor activity.3 The authors suggested that the small number of participants who experienced manic symptoms might explain the inconsistency.2