Depression is a serious mood disorder that is especially common among teens, with up to 20% of adolescents experiencing a major depressive episode in the past year. The need for mental health services that help teens manage and treat their symptoms has never been greater, but these services are not always available or easy to access. Making continuous mental health monitoring a part of routine medical care is one way to bridge this gap and ensure that teens with depression receive increased support when they need it.
This type of ongoing monitoring can be a labor-intensive process for both providers and patients, requiring frequent check-ins to assess patients’ current health status and changes in their health over time. However, current smartphone technology offers a means of collecting and evaluating much of this health data with minimal effort. In a project funded by the National Institute of Mental Health (NIMH) Small Business Technology Transfer program, researchers are investigating whether this technology can be used to create a passive monitoring system that can predict teens’ depressive symptoms and improve the quality of their care.
The two-phase study—led by Sami Shaaban of NuRelm Inc., Ana Radovic, MD, MSc, of the University of Pittsburgh, and Afsaneh Doryab, PhD, of the University of Virginia—focuses on an app called MoodRing Enhanced Care, which passively collects smartphone data on teens’ communication patterns and social media use, as well as Fitbit data reflecting their physical activity, sleep, and heart rate. The teens, their parents, and their health care providers all have access to an online platform where they can view and discuss the data.
The first phase of the study aims to fine-tune MoodRing’s predictive algorithm. In this phase, the research team will investigate whether MoodRing can use the passively collected data to predict teens’ self-reported depressive symptoms with at least 85% accuracy. If so, the researchers will conduct a randomized controlled trial in the second phase of the study that compares the efficacy of using the app in a primary care setting versus receiving typical care over a 6-month period.
In the second phase, the teens’ care managers will learn about the technical components and capabilities of MoodRing. However, they will not receive any instructions about medical decision making or be asked to take any steps outside of the typical scope of their practice. If care managers become concerned about a participant’s symptoms, they may decide to refer the participant for a follow-up appointment with a health care provider. The health care provider and participant can then decide the best approach to managing depressive symptoms as part of the follow-up visit.
The researchers will examine whether MoodRing leads to improvements in teens’ mental health care by measuring their symptoms and adherence to the treatment plan over time. The researchers will also examine secondary outcome measures, such as the extent to which the teens utilize care services and participants’ overall satisfaction with the app.
The researchers hypothesize that using the app may also benefit teens’ sense of self-efficacy and social support. By engaging in the monitoring process, the teens may develop the awareness and skills to identify, track, and manage their own symptoms over time. The app also provides a safe place for teens to talk about their well-being with their parents and their health care providers. The research team will investigate whether these individual-level factors—including feelings of self-efficacy and social support, knowledge and skills, and perceived symptom severity—impact overall outcomes.
By making symptom monitoring a part of routine medical care, the hope is that these new technologies can help improve teens’ symptoms and overall functioning, decrease their need for acute and crisis services, and stem the demand for more intensive mental health services.