Smartphone-based interventions in bipolar disorder: Systematic review and meta-analyses of efficacy. A position paper from the International Society for Bipolar Disorders (ISBD) Big Data Task Force

Gerard Anmella, Maria Faurholt-Jepsen, Diego Hidalgo-Mazzei, Joaquim Radua, Ives C Passos, Flavio Kapczinski, Luciano Minuzzi, Martin Alda, Sandra Meier, Tomas Hajek, Pedro Ballester, Boris Birmaher, Danella Hafeman, Tina Goldstein, Elisa Brietzke, Anne Duffy, Benno Haarman, Carlos López-Jaramillo, Lakshmi N Yatham, Raymond W LamErkki Isometsa, Rodrigo Mansur, Roger S McIntyre, Benson Mwangi, Eduard Vieta, Lars Vedel Kessing

13 Citationer (Scopus)

Abstract

BACKGROUND: The clinical effects of smartphone-based interventions for bipolar disorder (BD) have yet to be established.

OBJECTIVES: To examine the efficacy of smartphone-based interventions in BD and how the included studies reported user-engagement indicators.

METHODS: We conducted a systematic search on January 24, 2022, in PubMed, Scopus, Embase, APA PsycINFO, and Web of Science. We used random-effects meta-analysis to calculate the standardized difference (Hedges' g) in pre-post change scores between smartphone intervention and control conditions. The study was pre-registered with PROSPERO (CRD42021226668).

RESULTS: The literature search identified 6034 studies. Thirteen articles fulfilled the selection criteria. We included seven RCTs and performed meta-analyses comparing the pre-post change in depressive and (hypo)manic symptom severity, functioning, quality of life, and perceived stress between smartphone interventions and control conditions. There was significant heterogeneity among studies and no meta-analysis reached statistical significance. Results were also inconclusive regarding affective relapses and psychiatric readmissions. All studies reported positive user-engagement indicators.

CONCLUSION: We did not find evidence to support that smartphone interventions may reduce the severity of depressive or manic symptoms in BD. The high heterogeneity of studies supports the need for expert consensus to establish ideally how studies should be designed and the use of more sensitive outcomes, such as affective relapses and psychiatric hospitalizations, as well as the quantification of mood instability. The ISBD Big Data Task Force provides preliminary recommendations to reduce the heterogeneity and achieve more valid evidence in the field.

OriginalsprogEngelsk
TidsskriftBipolar Disorders
Vol/bind24
Udgave nummer6
Sider (fra-til)580-614
Antal sider35
ISSN1398-5647
DOI
StatusUdgivet - sep. 2022

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