Abstract
BackgroundPsychiatric disorders often have an onset at an early age, and early identification and intervention help improve prognosis. A fine-grained, unobtrusive, and effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and potentially lead to a more efficient use of clinical resources in the current health care system. The use of smartphones to monitor and treat children, adolescents, and young adults with psychiatric disorders has been widely investigated. However, no systematic review concerning smartphone-based monitoring and treatment in this population has been published.ObjectiveThis systematic review aims at describing the following 4 features of the eligible studies: (1) monitoring features such as self-assessment and automatically generated data, (2) treatment delivered by the app, (3) adherence to self-monitoring, and (4) results of the individual studies.MethodsWe conducted a systematic literature search of the PubMed, Embase, and PsycInfo databases. We searched for studies that (1) included a smartphone app to collect self-monitoring data, a smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had participants who were younger than 25 years; and (4) were published in a peer-reviewed journal. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias in each individual study was systematically assessed.ResultsA total of 2546 unique studies were identified through literature search; 15 of these fulfilled the criteria for inclusion. These studies covered 8 different diagnostic groups: psychosis, eating disorders, depression, autism, self-harm, anxiety, substance abuse, and suicidal behavior. Smartphone-based self-monitoring was used in all but 1 study, and 11 of them reported on the participants’ adherence to self-monitoring. Most studies were feasibility/pilot studies, and all studies on feasibility reported positive attitudes toward the use of smartphones for self-monitoring. In 2 studies, automatically generated data were collected. Three studies were randomized controlled trials investigating the effectiveness of smartphone-based monitoring and treatment, with 2 of these showing a positive treatment effect. In 2 randomized controlled trials, the researchers were blinded for randomization, but the participants were not blinded in any of the studies. All studies were determined to be at high risk of bias in several areas.ConclusionsSmartphones hold great potential as a modern, widely available technology platform to help diagnose, monitor, and treat psychiatric disorders in children and adolescents. However, a higher level of homogeneity and rigor among studies regarding their methodology and reporting of adherence would facilitate future reviews and meta-analyses.
Highlights
BackgroundPsychiatric disorders often have an onset of symptoms at an early age, and 3 out of 4 patients with mental disorders have an onset of symptoms before the age of 24 years [1]
We searched for studies that (1) included a smartphone app to collect self-monitoring data, a smartphone app to collect automatically generated smartphone-based data, or a smartphone-based system for treatment; (2) had participants who were diagnosed with psychiatric disorders or received treatment for a psychiatric disorder, which was verified by an external clinician; (3) had participants who were younger than 25 years; and (4) were published in a peer-reviewed journal
This systematic review identified 15 individual studies examining the use of smartphone-based monitoring and treatment of children, adolescents, and young adults with psychiatric disorders, who were referred by external clinicians, thereby covering 8 different diagnostic categories
Summary
BackgroundPsychiatric disorders often have an onset of symptoms at an early age, and 3 out of 4 patients with mental disorders have an onset of symptoms before the age of 24 years [1]. According to the World Health Organization, mental health problems account for 16% of the global burden of disease in people aged 10-19 years [2] For these patients, the early identification of symptoms and interventions may potentially lead to significant improvement in their quality of life, level of function, sense of empowerment, and prognosis [3]. The early identification of symptoms and interventions may potentially lead to significant improvement in their quality of life, level of function, sense of empowerment, and prognosis [3] Markers such as blood tests, radiologic findings, or electrophysiological measurements are insufficient for supporting the diagnostic assessment of psychiatric disorders and the severity of the symptoms. A fine-grained, unobtrusive, and effective way to monitor symptoms and level of function could help distinguish severe psychiatric health problems from normal behavior and potentially lead to a more efficient use of clinical resources in the current health care system. No systematic review concerning smartphone-based monitoring and treatment in this population has been published
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