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The Efficacy of Smartphone-Based Interventions in Bipolar Disorder

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Digital Mental Health

Abstract

Smartphones allow the automatic and continuous collection of real-time self-reported and passive objective behavioral data, which have the potential to avoid inherent biases and complement standardized mental health assessments. Bipolar disorder (BD) represents the ideal diagnostic framework for capturing digital information, as its depressive and manic phases overtly translate into altered emotion, speech, and behavior. Smartphones offer unique capabilities to detect prodromal affective symptoms between outpatient visits in BD and, therefore, potential for facilitating early interventions. Even smartphone-based interventions have shown some efficacy for depression and anxiety, their efficacy for BD is still unclear.

The heterogeneity of studies assessing smartphone-based interventions in BD so far fostered the development by the International Society for Bipolar Disorders (ISBD) Big Data Task Force of an expert consensus to establish how studies assessing the efficacy of smartphone-based interventions for BD should be designed and report user-engagement indicators objectively. This consensus will allow clinicians to compare and replicate studies and reach higher scientific rigor, qualitatively and quantitatively classify and rank smartphone-based interventions, and have accurate and reliable UEI to evaluate smartphone-based interventions in BD.

Smartphones could provide global, cost-effective, and evidence-based mental health services on demand and in real time. However, there are still many challenges still to be addressed that need the cooperation of multiple and distinct parties involved. This chapter provides an overview of the state-of-the-art efficacy of smartphone-based interventions for BD, the current challenges, barriers, and future directions.

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Abbreviations

app:

Smartphone application

BD:

Bipolar disorder

CBT:

Cognitive-behavioral therapy

EMA:

Ecological momentary assessments

ISBD:

International Society for Bipolar Disorders

mHealth:

Mobile health

PROMS:

Patient-reported outcome measures

PTSD:

Post-traumatic stress disorder

RCT:

Randomized controlled trials

SIMPLe:

Smartphone-based psychoeducational program for bipolar disorder

SM:

Self-monitoring

SMS:

Short message services

TAU:

Treatment-as-usual

UEIs:

User-engagement indicators

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Acknowledgements

Gerard Anmella is supported by a Rio Hortega 2021 grant (CM21/00017) from the Spanish Ministry of Health financed by the Instituto de Salud Carlos III (ISCIII) and co-financed by the Fondo Social Europeo Plus (FSE+).

Diego Hidalgo-Mazzei´s research is supported by a Juan Rodés JR18/00021 granted by the Instituto de Salud Carlos III (ISCIII). We would like to thank the PADRIS Programme for their administrative and statistical support as well as the CERCA Programme, and the Generalitat de Catalunya for the institutional support.

Eduard Vieta thanks the support of the Spanish Ministry of Science, Innovation and Universities (PI15/00283, PI18/00805, PI19/00394, CPII19/00009) integrated into the Plan Nacional de I+D+I and co-financed by the Instituto de Salud Carlos III (ISCIII)-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the ISCIII; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), and the CERCA Programme/Generalitat de Catalunya. We would like to thank the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357.

Conflicts of Interest

Gerard Anmella has received CME-related honoraria, or consulting fees from Janssen-Cilag, Lundbeck, Lundbeck/Otsuka, and Angelini, with no financial or other relationship relevant to the subject of this article.

Diego Hidalgo-Mazzei has received CME-related honoraria or adviser from Abbott, Angelini, Janssen-Cilag and Ethypharm with no financial or other relationship relevant to the subject of this article.

Eduard Vieta has received research support from or served as consultant, adviser or speaker for AB-Biotics, Abbott, Allergan, Angelini, Biogen, Boehringer-Ingelheim, Celon, Dainippon Sumitomo Pharma, Ethyphram, Ferrer, Gedeon Richter, GH Research, Glaxo-Smith Kline, Janssen, Lundbeck, Novartis, Otsuka, Rovi, Sage pharmaceuticals, Sanofi-Aventis, Shire, Sunovion, Takeda, Viatris, outside the submitted work, and reports no financial or other relationship relevant to the subject of this article.

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  1. Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain

    Gerard Anmella, Diego Hidalgo-Mazzei & Eduard Vieta

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  1. Gerard Anmella
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  2. Diego Hidalgo-Mazzei
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Correspondence to Eduard Vieta .

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Editors and Affiliations

  1. Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Ives Cavalcante Passos

  2. Department of Social, Genetic and Developmental Psychiatry, King’s College of London, London, UK

    Francisco Diego Rabelo-da-Ponte

  3. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Flavio Kapczinski

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Anmella, G., Hidalgo-Mazzei, D., Vieta, E. (2023). The Efficacy of Smartphone-Based Interventions in Bipolar Disorder. In: Passos, I.C., Rabelo-da-Ponte, F.D., Kapczinski, F. (eds) Digital Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-031-10698-9_7

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