A web-based survey found that many people with bipolar disorder (BD) used commercial smartphone applications for BD self-management. These findings were published in International Journal of Bipolar Disorders.

This study recruited individuals with BD via advertisements on social media and through the Collaborative RESearch Team to study psychosocial issues in Bipolar Disorder (CREST.BD) website and its mailing list. Participants (N=919) completed an online survey which evaluated BD symptoms and the use of smartphone applications for symptom management.

The participants comprised 77.9% women, aged mean 36.9 (SD, 12) years, 61% were White, 51.9% had self-reported BD II, 34.9% self-reported BD-I, 81.1% took medication for their BD, 47.7% were receiving counselling or psychotherapy, and 15.5% received peer support.


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The participants reported using applications to monitor mood (24.8%) and sleep (26.3%). A total of 110 unique applications were reported, among which 68.2% of the mood applications and 73.1% of the sleep applications were reported by only 1 participant.

The top 5 mood-related applications were used by 130 participants. The most frequently used applications were Daylio (n=59) and Bipolar eMoods Tracker (n=45). The top 5 sleep-related applications were used by 112 participants and the most popular were Fitbit (n=50) and Calm (n=24).

Calm was the most common application used for both mood and sleep self-management.

On the Apple iOS and Google Play stores, these applications were popular with an average rating of 4.6 out of 5. All applications were commercial with no university, health care, or government affiliation. Most applications were free to download but required in-app purchases to access content.

The applications related with mood had mood tracking (n=5), journaling (n=5), and sleep tracking (n=3) features. The sleep applications had mindfulness (n=4), sleep tracking (n=3), deep breathing exercises (n=3), health exercises (n=3), and journaling (n=3) features.

All the reviewed applications (n=9) had publicly available privacy policies and 7 described security measures. A total of 3 applications shared data with third parties. The Flesch-Kincaid grade-reading level of the policies was 13.45, suggesting a high-school education or some postsecondary education would be needed to read and understand the content.

A total of 6 applications had published evidence about feasibility or usability but only 2 mood-related and 4 sleep-related applications had evidence to support their efficacy.

The results of this study may not be generalizable, as the study population was predominated by White women who were employed and had completed some form of secondary education.

The study authors concluded, “Taken together, these findings reinforce the importance of contextualizing app evaluations according to real-world usage rates, through demonstrating that the earlier reviews of the BD app landscape are not necessarily reflective of apps most commonly used in real-world contexts. Rather, people with BD tended to use apps designed for the general population to support and monitor their mood and sleep.”

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Morton E, Nicholas J, Yang L, et al. Evaluating the quality, safety, and functionality of commonly used smartphone apps for bipolar disorder mood and sleep self‑management. Int J Bipolar Disord. 2022;10(1):10. doi:10.1186/s40345-022-00256-6