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Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening

INTRODUCTION: Major depression affects over 300 million people worldwide, but cases are often detected late or remain undetected. This increases the risk of symptom deterioration and chronification. Consequently, there is a high demand for low threshold but clinically sound approaches to depression...

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Autores principales: Burchert, Sebastian, Kerber, André, Zimmermann, Johannes, Knaevelsrud, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787464/
https://www.ncbi.nlm.nih.gov/pubmed/33406120
http://dx.doi.org/10.1371/journal.pone.0244955
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author Burchert, Sebastian
Kerber, André
Zimmermann, Johannes
Knaevelsrud, Christine
author_facet Burchert, Sebastian
Kerber, André
Zimmermann, Johannes
Knaevelsrud, Christine
author_sort Burchert, Sebastian
collection PubMed
description INTRODUCTION: Major depression affects over 300 million people worldwide, but cases are often detected late or remain undetected. This increases the risk of symptom deterioration and chronification. Consequently, there is a high demand for low threshold but clinically sound approaches to depression detection. Recent studies show a great willingness among users of mobile health apps to assess daily depression symptoms. In this pilot study, we present a provisional validation of the depression screening app Moodpath. The app offers a 14-day ambulatory assessment (AA) of depression symptoms based on the ICD-10 criteria as well as ecologically momentary mood ratings that allow the study of short-term mood dynamics. MATERIALS AND METHODS: N = 113 Moodpath users were selected through consecutive sampling and filled out the Patient Health Questionnaire (PHQ-9) after completing 14 days of AA with 3 question blocks (morning, midday, and evening) per day. The psychometric properties (sensitivity, specificity, accuracy) of the ambulatory Moodpath screening were assessed based on the retrospective PHQ-9 screening result. In addition, several indicators of mood dynamics (e.g. average, inertia, instability), were calculated and investigated for their individual and incremental predictive value using regression models. RESULTS: We found a strong linear relationship between the PHQ-9 score and the AA Moodpath depression score (r = .76, p < .001). The app-based screening demonstrated a high sensitivity (.879) and acceptable specificity (.745). Different indicators of mood dynamics covered substantial amounts of PHQ-9 variance, depending on the number of days with mood data that were included in the analyses. DISCUSSION: AA and PHQ-9 shared a large proportion of variance but may not measure exactly the same construct. This may be due to the differences in the underlying diagnostic systems or due to differences in momentary and retrospective assessments. Further validation through structured clinical interviews is indicated. The results suggest that ambulatory assessed mood indicators are a promising addition to multimodal depression screening tools. Improving app-based AA screenings requires adapted screening algorithms and corresponding methods for the analysis of dynamic processes over time.
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spelling pubmed-77874642021-01-14 Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening Burchert, Sebastian Kerber, André Zimmermann, Johannes Knaevelsrud, Christine PLoS One Research Article INTRODUCTION: Major depression affects over 300 million people worldwide, but cases are often detected late or remain undetected. This increases the risk of symptom deterioration and chronification. Consequently, there is a high demand for low threshold but clinically sound approaches to depression detection. Recent studies show a great willingness among users of mobile health apps to assess daily depression symptoms. In this pilot study, we present a provisional validation of the depression screening app Moodpath. The app offers a 14-day ambulatory assessment (AA) of depression symptoms based on the ICD-10 criteria as well as ecologically momentary mood ratings that allow the study of short-term mood dynamics. MATERIALS AND METHODS: N = 113 Moodpath users were selected through consecutive sampling and filled out the Patient Health Questionnaire (PHQ-9) after completing 14 days of AA with 3 question blocks (morning, midday, and evening) per day. The psychometric properties (sensitivity, specificity, accuracy) of the ambulatory Moodpath screening were assessed based on the retrospective PHQ-9 screening result. In addition, several indicators of mood dynamics (e.g. average, inertia, instability), were calculated and investigated for their individual and incremental predictive value using regression models. RESULTS: We found a strong linear relationship between the PHQ-9 score and the AA Moodpath depression score (r = .76, p < .001). The app-based screening demonstrated a high sensitivity (.879) and acceptable specificity (.745). Different indicators of mood dynamics covered substantial amounts of PHQ-9 variance, depending on the number of days with mood data that were included in the analyses. DISCUSSION: AA and PHQ-9 shared a large proportion of variance but may not measure exactly the same construct. This may be due to the differences in the underlying diagnostic systems or due to differences in momentary and retrospective assessments. Further validation through structured clinical interviews is indicated. The results suggest that ambulatory assessed mood indicators are a promising addition to multimodal depression screening tools. Improving app-based AA screenings requires adapted screening algorithms and corresponding methods for the analysis of dynamic processes over time. Public Library of Science 2021-01-06 /pmc/articles/PMC7787464/ /pubmed/33406120 http://dx.doi.org/10.1371/journal.pone.0244955 Text en © 2021 Burchert et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Burchert, Sebastian
Kerber, André
Zimmermann, Johannes
Knaevelsrud, Christine
Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
title Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
title_full Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
title_fullStr Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
title_full_unstemmed Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
title_short Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening
title_sort screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: comparison with the phq-9 depression screening
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787464/
https://www.ncbi.nlm.nih.gov/pubmed/33406120
http://dx.doi.org/10.1371/journal.pone.0244955
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