Tracking and Monitoring Mood Stability of Patients With Major Depressive Disorder by Machine Learning Models Using Passive Digital Data: Prospective Naturalistic Multicenter Study

BACKGROUND: Major depressive disorder (MDD) is a common mental illness characterized by persistent sadness and a loss of interest in activities. Using smartphones and wearable devices to monitor the mental condition of patients with MDD has been examined in several studies. However, few studies have used passively collected data to monitor mood changes over time. OBJECTIVE: The aim of this study is to examine the feasibility of monitoring mood status and stability of patients with MDD using machine learning models trained by passively collected data, including phone use data, sleep data, and step count data. METHODS: We constructed 950 data samples representing time spans during three consecutive Patient Health Questionnaire-9 assessments. Each data sample was labeled as Steady or Mood Swing, with subgroups Steady-remission, Steady-depressed, Mood Swing-drastic, and Mood Swing-moderate based on patients’ Patient Health Questionnaire-9 scores from three visits. A total of 252 features were extracted, and 4 feature selection models were applied; 6 different combinations of types of data were experimented with using 6 different machine learning models. RESULTS: A total of 334 participants with MDD were enrolled in this study. The highest average accuracy of classification between Steady and Mood Swing was 76.67% (SD 8.47%) and that of recall was 90.44% (SD 6.93%), with features from all types of data being used. Among the 6 combinations of types of data we experimented with, the overall best combination was using call logs, sleep data, step count data, and heart rate data. The accuracies of predicting between Steady-remission and Mood Swing-drastic, Steady-remission and Mood Swing-moderate, and Steady-depressed and Mood Swing-drastic were over 80%, and the accuracy of predicting between Steady-depressed and Mood Swing-moderate and the overall Steady to Mood Swing classification accuracy were over 75%. Comparing all 6 aforementioned combinations, we found that the overall prediction accuracies between Steady-remission and Mood Swing (drastic and moderate) are better than those between Steady-depressed and Mood Swing (drastic and moderate). CONCLUSIONS: Our proposed method could be used to monitor mood changes in patients with MDD with promising accuracy by using passively collected data, which can be used as a reference by doctors for adjusting treatment plans or for warning patients and their guardians of a relapse. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900021461; http://www.chictr.org.cn/showprojen.aspx?proj=36173