Abstract
Recently, there has been an increase in the production of devices to monitor mental health and stress as means for expediting detection, and subsequent management of these conditions. The objective of this review is to identify and critically appraise the most recent smart devices and wearable technologies used to identify depression, anxiety, and stress, and the physiological process(es) linked to their detection. The MEDLINE, CINAHL, Cochrane Central, and PsycINFO databases were used to identify studies which utilised smart devices and wearable technologies to detect or monitor anxiety, depression, or stress. The included articles that assessed stress and anxiety unanimously used heart rate variability (HRV) parameters for detection of anxiety and stress, with the latter better detected by HRV and electroencephalogram (EGG) together. Electrodermal activity was used in recent studies, with high accuracy for stress detection; however, with questionable reliability. Depression was found to be largely detected using specific EEG signatures; however, devices detecting depression using EEG are not currently available on the market. This systematic review highlights that average heart rate used by many commercially available smart devices is not as accurate in the detection of stress and anxiety compared with heart rate variability, electrodermal activity, and possibly respiratory rate.
Highlights
IntroductionIn conjunction with negative emotions such as anxiety and depression, stress can increase cardiovascular disease risk, the leading cause of mortality worldwide [3]
A further 265 studies were excluded following a review of their title and abstract, with studies excluded if the abstract did not mention the use of wearable technologies or smart devices for detection of stress, anxiety, or depression
Based off the wearable devices yielded by the aforementioned search terms, heart rate variability (HRV) was identified as the most useful physiological metric for detection of stress and anxiety [9,17,23]
Summary
In conjunction with negative emotions such as anxiety and depression, stress can increase cardiovascular disease risk, the leading cause of mortality worldwide [3]. Anxiety disorders are the leading mental health illness, with 264 million affected worldwide [4], with depression projected to be the second major cause of disability in the coming decade [5]. Researchers are trying to create more compact, portable, and accurate technology to monitor stress and mental health status (depression or anxiety). Such devices will reduce morbidity and the economic burden on the health care system, as patients can seek help earlier or act to reduce symptoms or triggers [6,7]
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