Abstract
BackgroundAlthough a growing body of literature highlights the potential benefit of smartphone-based mobile apps to aid in self-management and treatment of bipolar disorder, it is unclear whether such evidence-based apps are readily available and accessible to a user of the app store.ResultsUsing our systematic framework for the evaluation of mental health apps, we analyzed the accessibility, privacy, clinical foundation, features, and interoperability of the top-returned 100 apps for bipolar disorder. Only 56% of the apps mentioned bipolar disorder specifically in their title, description, or content. Only one app’s efficacy was supported in a peer-reviewed study, and 32 apps lacked privacy policies. The most common features provided were mood tracking, journaling, and psychoeducation.ConclusionsOur analysis reveals substantial limitations in the current digital environment for individuals seeking an evidence-based, clinically usable app for bipolar disorder. Although there have been academic advances in development of digital interventions for bipolar disorder, this work has yet to be translated to the publicly available app marketplace. This unmet need of digital mood management underscores the need for a comprehensive evaluation system of mental health apps, which we have endeavored to provide through our framework and accompanying database (apps.digitalpsych.org).
Highlights
A growing body of literature highlights the potential benefit of smartphone-based mobile apps to aid in self-management and treatment of bipolar disorder, it is unclear whether such evidence-based apps are readily available and accessible to a user of the app store
Of the first 107 bipolar disorder related apps, nine (8%) were inaccessible without an access code or unavailable in English, and a total of 98 iOS bipolar disorder apps were evaluated with our framework (Fig. 1)
Function and relevance In the iOS Store, apps returned on a search bipolar disorder (BD) were categorized in Business (n = 1), Education (n = 4), Entertainment (n = 2), Games (n = 13), Health and Fitness (n = 34), Lifestyle (n = 19), Magazine and Newspaper (n = 1), Medical (n = 19), Productivity (n = 2), Social Networking (n = 3), and Stickers (n = 2)
Summary
A growing body of literature highlights the potential benefit of smartphone-based mobile apps to aid in self-management and treatment of bipolar disorder, it is unclear whether such evidence-based apps are readily available and accessible to a user of the app store. Smartphone apps can enable both active (user-inputted) and passive (automatically collected) data collection to aid in BD diagnostics, advance evidence-based treatments like social rhythm therapy, and self-management (Torous and Powell 2015). Digital phenotyping—deriving metrics like location and activity patterns, social phone utilization, and symptom change—are emerging as mobile target interventions for BD (Huckvale et al 2019) These metrics may help elucidate digital biomarkers to detect both diagnostic mood status and symptom change (Ortiz and Grof 2016), facilitating the potential for early relapse detection (Jacobson et al 2019; Faurholt-Jepsen et al 2019b). Digital phenotyping is the latest promising avenue of exploration, adding to the robust base of literature supporting the efficacy of and receptiveness to smartphone interventions for BD
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